[Federal Register Volume 81, Number 210 (Monday, October 31, 2016)]
[Notices]
[Pages 75406-75408]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-26246]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-416, CMS-8003, CMS-10142, CMS-10396, and 
CMS-R-262]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

ACTION: Notice.

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SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is 
announcing an opportunity for the public to comment on CMS' intention 
to collect information from the public. Under the Paperwork Reduction 
Act of 1995 (the PRA), federal agencies are required to publish notice 
in the Federal Register concerning each proposed collection of 
information (including each proposed extension or reinstatement of an 
existing collection of information) and to allow 60 days for public 
comment on the proposed action. Interested persons are invited to send 
comments regarding our burden estimates or any other aspect of this 
collection of information, including any of the following subjects: (1) 
The necessity and utility of the proposed information collection for 
the proper performance of the agency's functions; (2) the accuracy of 
the estimated burden; (3) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (4) the use of 
automated collection techniques or

[[Page 75407]]

other forms of information technology to minimize the information 
collection burden.

DATES: Comments must be received by December 30, 2016.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number. To be assured consideration, comments and 
recommendations must be submitted in any one of the following ways:
    1. Electronically. You may send your comments electronically to 
http://www.regulations.gov. Follow the instructions for ``Comment or 
Submission'' or ``More Search Options'' to find the information 
collection document(s) that are accepting comments.
    2. By regular mail. You may mail written comments to the following 
address: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: Document Identifier/OMB 
Control Number ___, Room C4-26-05, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.
    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, you may make 
your request using one of following:
    1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to [email protected].
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.

SUPPLEMENTARY INFORMATION:

Contents

    This notice sets out a summary of the use and burden associated 
with the following information collections. More detailed information 
can be found in each collection's supporting statement and associated 
materials (see ADDRESSES).

CMS-416 Annual Early and Periodic Screening, Diagnostic and Treatment 
(EPSDT) Participation Report
CMS-8003 1915(c) Home and Community Based Services (HCBS) Waiver
CMS-10142 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and 
Prescription Drug Plans (PDP)
CMS-10396 Medication Therapy Management Program Improvements
CMS-R-262 Contract Year 2018 Plan Benefit Package (PBP) Software and 
Formulary Submission


    Under the PRA (44 U.S.C. 3501-3520), federal agencies must obtain 
approval from the Office of Management and Budget (OMB) for each 
collection of information they conduct or sponsor. The term 
``collection of information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 
1320.3(c) and includes agency requests or requirements that members of 
the public submit reports, keep records, or provide information to a 
third party. Section 3506(c)(2)(A) of the PRA requires federal agencies 
to publish a 60-day notice in the Federal Register concerning each 
proposed collection of information, including each proposed extension 
or reinstatement of an existing collection of information, before 
submitting the collection to OMB for approval. To comply with this 
requirement, CMS is publishing this notice.

Information Collection

    1. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Annual Early and 
Periodic Screening, Diagnostic and Treatment (EPSDT) Participation 
Report; Use: The collected baseline data is used to assess the 
effectiveness of state early and periodic screening, diagnostic and 
treatment (EPSDT) programs in reaching eligible children (by age group 
and basis of Medicaid eligibility) who are provided initial and 
periodic child health screening services, referred for corrective 
treatment, and receiving dental, hearing, and vision services. This 
assessment is coupled with the state's results in attaining the 
participation goals set for the state. The information gathered from 
this report, permits federal and state managers to evaluate the 
effectiveness of the EPSDT law on the basic aspects of the program. 
Form Number: CMS-416 (OMB control number 0938-0354); Frequency: Yearly 
and on occasion; Affected Public: State, Local, or Tribal Governments; 
Number of Respondents: 56; Total Annual Responses: 168; Total Annual 
Hours: 1,624. (For policy questions regarding this collection contact 
Kimberly Perrault at 410-786-2482.)
    2. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
1915(c) Home and Community Based Services (HCBS) Waiver; Use: We will 
use the web-based application to review and adjudicate individual 
waiver actions. The web-based application will also be used by states 
to submit and revise their waiver requests. Form Number: CMS-8003 (OMB 
control number 0938-0449); Frequency: Yearly; Affected Public: State, 
Local, or Tribal Governments; Number of Respondents: 47; Total Annual 
Responses: 71; Total Annual Hours: 6,005. (For policy questions 
regarding this collection contact Kathy Poisal at 410-786-5940.)
    3. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Bid Pricing Tool 
(BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans 
(PDP); Use: We require that Medicare Advantage organizations and 
Prescription Drug Plans complete the BPT as part of the annual bidding 
process. During this process, organizations prepare their proposed 
actuarial bid pricing for the upcoming contract year and submit them to 
us for review and approval. The purpose of the BPT is to collect the 
actuarial pricing information for each plan. The BPT calculates the 
plan's bid, enrollee premiums, and payment rates. We publish 
beneficiary premium information using a variety of formats 
(www.medicare.gov, the Medicare & You handbook, Summary of Benefits 
marketing information) for the purpose of beneficiary education and 
enrollment. Form Number: CMS-10142 (OMB control number 0938-0944); 
Frequency: Yearly; Affected Public: Business or other for-profits and 
Not-for-profit institutions; Number of Respondents: 555; Total Annual 
Responses: 4,995; Total Annual Hours: 149,850. (For policy questions 
regarding this collection contact Rachel Shevland at 410-786-3026.)
    4. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medication 
Therapy Management Program Improvements; Use: Information collected by 
Part D medication therapy management programs (as required by the 
standardized format for the comprehensive medication review summary) 
will be used by beneficiaries or their authorized representatives, 
caregivers, and their healthcare providers to improve medication use 
and achieve better healthcare outcomes. Form Number: CMS-10396 (OMB 
control number 0938-1154); Frequency: Occasionally; Affected Public: 
Business or other for-profits; Number of Respondents: 599; Total Annual 
Responses: 1,211,661; Total Annual Hours: 807,451. (For policy 
questions regarding this collection contact Victoria Dang at 410-786-
3991.)

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    5. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Contract Year 
2018 Plan Benefit Package (PBP) Software and Formulary Submission; Use: 
We require that Medicare Advantage and Prescription Drug Plan 
organizations submit a completed PBP and formulary as part of the 
annual bidding process. During this process, organizations prepare 
their proposed plan benefit packages for the upcoming contract year and 
submit them to us for review and approval. We publish beneficiary 
education information using a variety of formats. The specific 
education initiatives that utilize PBP and formulary data include web 
application tools on www.medicare.gov and the plan benefit insert in 
the Medicare & You handbook. In addition, organizations utilize the PBP 
data to generate their Summary of Benefits marketing information. Form 
Number: CMS-R-262 (OMB control number 0938-0763); Frequency: Yearly; 
Affected Public: Business or other for-profits and Not-for-profit 
institutions; Number of Respondents: 524; Total Annual Responses: 
5,185; Total Annual Hours: 50,619. (For policy questions regarding this 
collection contact Kristy Holtje at 410-786-2209.)

    Dated: October 26, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2016-26246 Filed 10-28-16; 8:45 am]
BILLING CODE 4120-01-P