[Federal Register Volume 81, Number 214 (Friday, November 4, 2016)]
[Notices]
[Pages 76945-76946]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-26745]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-3070G-I, CMS-R-38 and CMS-10636]


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

DATES: Comments must be received by January 3, 2017.

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).

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CMS-3070G-I............................  ICF/IID Survey Report Form and
                                          Supporting Regulations.
CMS-R-38...............................  Conditions for Certification
                                          for Rural Health Clinics.
CMS-10636..............................  Three-Year Network Adequacy
                                          Review for Medicare Advantage
                                          Organizations.
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    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

[[Page 76946]]

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: ICF/IID Survey 
Report Form and Supporting Regulations; Use: The information collected 
with forms 3070G-I is used to determine the level of compliance with 
Intermediate Care Facilities for Individuals with Intellectual 
Disabilities (ICF/IID) CoPs necessary to participate in the Medicare/
Medicaid program. Information needed to monitor the State's performance 
as well as the ICF/IID program in general, is available to CMS only 
through the use of information abstracted from the survey report form. 
The form serves as a coding worksheet designed to facilitate data entry 
and retrieval into the Automated Survey Processing Environment Suite 
(ASPEN) in the State and at the CMS regional offices. Form Number: CMS-
3070G-I (OMB Control Number: 0938-0062); Frequency: Reporting--Yearly; 
Affected Public: Private Sector: Business or other for-profits and Not-
for-profit institutions; Number of Respondents: 6,310; Total Annual 
Responses: 6,310; Total Annual Hours: 18,930. (For policy questions 
regarding this collection contact Melissa Rice at 410-786-3270.)
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Conditions for 
Certification for Rural Health Clinics; Use: The Rural Health Clinic 
(RHC) conditions of certification are based on criteria prescribed in 
law and are designed to ensure that each facility has a properly 
trained staff to provide appropriate care and to assure a safe physical 
environment for patients. We use these conditions of participation to 
certify RHCs wishing to participate in the Medicare program. These 
requirements are similar in intent to standards developed by industry 
organizations such as the Joint Commission on Accreditation of 
Hospitals, and the National League of Nursing and the American Public 
Association and merely reflect accepted standards of management and 
care to which rural health clinics must adhere. Form Number: CMS-R-38 
(OMB control number: 0938-0334); Frequency: Recordkeeping and 
Reporting--Annually; Affected Public: Business or other for-profits; 
Number of Respondents: 4,247; Total Annual Responses: 4,247; Total 
Annual Hours: 18,284. (For policy questions regarding this collection 
contact Jacqueline Leach at 410-786-4282.)
    3. Type of Information Collection Request: New collection (Request 
for a new OMB control number); Title of Information Collection: Three-
Year Network Adequacy Review for Medicare Advantage Organizations; Use: 
The CMS regulations at 42 CFR 422.112(a)(1)(i) and Sec.  
422.114(a)(3)(ii) require that all Medicare Advantage organizations 
(MAOs) offering coordinated care plans (e.g., HMO, PPO) or other 
network-based plans (e.g., network-based PFFS, network-based MSA, 
section 1876 cost plan) maintain a network of appropriate providers 
that is sufficient to provide adequate access to covered services to 
meet the needs of the population served. To enforce this requirement, 
CMS has developed network adequacy criteria, which sets forth the 
minimum number of providers and maximum travel time and distance from 
enrollees to providers, for each provider specialty type in each county 
in the United States and its territories. MAOs must be in compliance 
with the current CMS network adequacy criteria. This proposed 
collection of information is essential to appropriate and timely 
compliance monitoring by CMS, in order to ensure that all active MAO 
contracts offering network-based plans maintain an adequate network. 
Currently, CMS verifies that MAOs are compliant with the current CMS 
network adequacy criteria by performing a contract-level network 
review, which occurs when CMS requests that an MAO upload provider and 
facility Health Service Delivery (HSD) tables for a given contract to 
the Health Plan Management System (HPMS). If an MAO does not have its 
contract-level network formally reviewed by CMS after the initial 
contract application process, then there is no CMS requirement for a 
network adequacy review unless one of the above listed triggering 
events occurs. Therefore, CMS is proposing this collection of 
information in order to improve monitoring of MAOs' network adequacy. 
This collection of information requires the uploading of HSD tables to 
the Network Management Module (NMM) in HPMS for any contract that has 
not had an entire network review performed by CMS in the previous three 
years of contract operation. The collection process will occur at the 
contract level for each MAO that qualifies, and CMS will assess each 
contract against the current CMS network adequacy criteria. Each time 
an MAO's contract undergoes an entire network review during any of the 
triggering events listed on page one, the three-year anniversary date 
for that contract will be reset, and CMS will maintain an HPMS report 
to keep track of this date for every active network-based contract. 
Form Number: CMS-10636 (OMB control number 0938-New); Frequency: 
Yearly; Affected Public: Private sector (Business or other for-
profits); Number of Respondents: 484; Total Annual Responses: 1,652; 
Total Annual Hours: 15,692. (For policy questions regarding this 
collection contact Theresa Wachter at 410-786-1157.)

    Dated: November 1, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2016-26745 Filed 11-3-16; 8:45 am]
 BILLING CODE 4120-01-P