[Federal Register Volume 82, Number 65 (Thursday, April 6, 2017)]
[Notices]
[Pages 16843-16844]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-06830]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-10147, CMS-10203, CMS-R-21, and CMS-R-148]


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 the necessity and utility of the 
proposed information collection for the proper performance of the 
agency's functions, the accuracy of the estimated burden, ways to 
enhance the quality, utility, and clarity of the information to be 
collected, and the use of automated collection techniques or other 
forms of information technology to minimize the information collection 
burden.

DATES: Comments must be received by June 5, 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 https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
    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: William Parham at (410) 786-4669.

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-10147 Medicare Prescription Drug Coverage and Your Rights
CMS-10203 Medicare Health Outcomes Survey (HOS)
CMS-R-21 Withholding Medicare Payments to Recover Medicaid

[[Page 16844]]

Overpayments and Supporting Regulations in 42 CFR 447.31
CMS-R-148 Limitations on Provider Related Donations and Health Care 
Related Taxes; Limitation on Payment to Disproportionate Share 
Hospitals; Medicaid and Supporting Regulations in 42 CFR 433.68, 433.74 
and 447.272

    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: Medicare 
Prescription Drug Coverage and Your Rights; Use: Through the delivery 
of this standardized notice, Part D plan sponsors' network pharmacies 
are in the best position to inform enrollees (at the point of sale) 
about how to contact their Part D plan if their prescription cannot be 
filled and how to request an exception to the Part D plan's formulary. 
The notice restates certain rights and protections related to the 
enrollees Medicare prescription drug benefits, including the right to 
receive a written explanation from the drug plan about why a 
prescription drug is not covered; Form Number: CMS-10147 (OMB control 
number: 0938-0975); Frequency: Occasionally; Affected Public: Private 
sector (business or other for-profits); Number of Respondents: 62,000; 
Total Annual Responses: 40,100,000; Total Annual Hours: 668,066. (For 
policy questions regarding this collection contact Sabrina Sparkman at 
410-786-3209.)
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Medicare Health 
Outcomes Survey (HOS); Use: The collection is necessary to hold 
Medicare managed care contracts accountable for the quality of care 
they deliver to beneficiaries. This reporting requirement allows us to 
obtain the information necessary for proper oversight of the Medicare 
Advantage program. It is critical to our mission that we collect and 
disseminate valid and reliable information that can be used to improve 
quality of care through identification of quality improvement 
opportunities, assist us in carrying out our oversight 
responsibilities, and help beneficiaries make an informed choice among 
health plans. Form Number: CMS-10203 (OMB control number: 0938-0701); 
Frequency: Yearly; Affected Public: Individuals and households; Number 
of Respondents: 739,959; Total Annual Responses: 554,895; Total Annual 
Hours: 183,115. (For policy questions regarding this collection contact 
Kimberly DeMichele at 410-786-4286.)
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Withholding 
Medicare Payments to Recover Medicaid Overpayments and Supporting 
Regulations in 42 CFR 447.31; Use: Certain Medicaid providers that are 
subject to offsets for the collection of Medicaid overpayments may 
terminate or substantially reduce their participation in Medicaid, 
leaving the state Medicaid agency unable to recover the amounts due. 
Recovery procedures allow for determining the amount of overpayments 
and offsetting the overpayments by withholding the provider's Medicare 
payments. To effectuate the withholding, the state agency must provide 
their respective CMS regional office with certain documentation that 
identifies the provider and the Medicaid overpayment amount. The agency 
must also demonstrate that the provider was notified of the overpayment 
and that demand for the overpayment was made. An opportunity to appeal 
the overpayment determination must be afforded to the provider by the 
Medicaid state agency. Lastly, Medicaid state agencies must notify CMS 
when to terminate the withholding; Form Number: CMS-R-21 (OMB control 
number: 0938-0287); Frequency: Occasionally; Affected Public: State, 
Local, or Tribal Governments; Number of Respondents: 54; Total Annual 
Responses: 27; Total Annual Hours: 81. (For policy questions regarding 
this collection contact Stuart Goldstein at 410-786-0694.)
    4. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Limitations on 
Provider Related Donations and Health Care Related Taxes; Limitation on 
Payment to Disproportionate Share Hospitals; Medicaid and Supporting 
Regulations in 42 CFR 433.68, 433.74 and 447.272; Use: States may 
request a waiver of the broad based and uniformity tax program 
requirements. Each state must demonstrate that its tax program(s) do 
not violate the hold harmless provision. Additionally, state Medicaid 
agencies must report (quarterly) on health care related taxes collected 
and the source of provider related donations received by the state or 
unit of local government. Each state must maintain, in readily 
reviewable form, supporting documentation that provides a detailed 
description of each donation and tax program being reported, as well as 
the source and use of all donations received and collected. Without 
this information, the amount of Federal financial participation payable 
to a state cannot be determined; Form Number: CMS-R-148 (OMB control 
number: 0938-0618); Frequency: Quarterly and occasionally; Affected 
Public: State, Local, or Tribal Governments; Number of Respondents: 50; 
Total Annual Responses: 40; Total Annual Hours: 3,200. (For policy 
questions regarding this collection contact Stuart Goldstein at 410-
786-0694.)

    Dated: April 3, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2017-06830 Filed 4-5-17; 8:45 am]
 BILLING CODE 4120-01-P