[Federal Register Volume 82, Number 142 (Wednesday, July 26, 2017)]
[Notices]
[Pages 34675-34677]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-15726]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-1984-14, CMS-10326, CMS-2088-17, CMS-10452, 
CMS-10320 and CMS-10418]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

ACTION: Notice.

-----------------------------------------------------------------------

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 (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 a second opportunity 
for public comment on the notice. Interested persons are invited to 
send comments regarding the burden estimate 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 on the collection(s) of information must be received by 
the OMB desk officer by August 25, 2017.

ADDRESSES: When commenting on the proposed information collections, 
please reference the document identifier or OMB control number. To be 
assured consideration, comments and recommendations must be received by 
the OMB desk officer via one of the following transmissions: OMB, 
Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-5806 OR, Email: 
[email protected].
    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 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: Under the Paperwork Reduction Act of 1995 
(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 (44 U.S.C.

[[Page 34676]]

3506(c)(2)(A)) requires federal agencies to publish a 30-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. No comments were received in response to the 60-day 
comment period. To comply with this requirement, CMS is publishing this 
notice that summarizes the following proposed collection(s) of 
information for public comment:
    1. Type of Information Collection Request: Reinstatement of a 
previously approved collection; Title of Information Collection: 
Hospice Facility Cost Report; Use: Providers of services participating 
in the Medicare program are required under Sec. Sec.  1815(a), 1833(e), 
and 1861(v)(1)(A) of the Social Security Act (42 U.S.C. 1395g) to 
submit annual information to determine costs for health care services 
rendered to Medicare beneficiaries. In addition, regulations at 42 CFR 
413.20, 413.24 and 418.310 require adequate cost data and cost reports 
from providers on an annual basis. The Form CMS-1984-14 cost report is 
needed to determine a provider's reasonable costs incurred in 
furnishing medical services to Medicare beneficiaries. The data is used 
by CMS to calculate: Market basket weight and the labor related shares, 
Rate setting and payment refinement, and Medicare and total facility 
margins for Medicare-covered services by type of service. Form Number: 
CMS-1984-14 (OMB control number: 0938-0758); Frequency: Annually; 
Affected Public: Private sector--Business or other for-profit and Not-
for-profit institutions; Number of Respondents: 3,545; Total Annual 
Responses: 3,545; Total Annual Hours: 666,460. (For policy questions 
regarding this collection contact Yaakov Feinstein at 410-786-3137.)
    2. Type of Information Collection Request: Reinstatement without 
change of a previously approved collection; Title of Information 
Collection: Electronic Submission of Medicare Graduate Medical 
Education (GME) Affiliation Agreements; Use: Sections 1886(h)(4)(F) and 
1886(d)(5)(B)(v) of the Act establish limits on the number of 
allopathic and osteopathic FTE residents that hospitals may count for 
purposes of calculating direct GME payments and the indirect medical 
education (IME) adjustment. In addition, under the authority granted by 
section 1886(h)(4)(H)(ii) of the Act, the Secretary issued regulations 
on May 12, 1998 (63 FR 26358) to allow institutions that are members of 
the same Medicare GME affiliated group to elect to apply their direct 
GME and IME FTE resident caps based on the aggregate cap of all 
hospitals that are part of a Medicare GME affiliation group. Under 
those regulations, specified at Sec.  413.79(f) for direct GME and at 
Sec.  412.105(f)(1)(vi) for IME, hospitals that are part of the same 
Medicare GME affiliated group are permitted to adjust each hospital's 
caps to reflect the rotation of residents among affiliated hospitals 
during an academic year. Under Sec.  413.75(b), a Medicare GME 
affiliated group may be formed by two or more hospitals if: (1) The 
hospitals are located in the same urban or rural area or in a 
contiguous area and have a shared rotational arrangement as specified 
at Sec.  413.79(f)(2); (2) the hospitals are not located in the same or 
in a contiguous area, but have a shared rotational arrangement and they 
are jointly listed as the sponsor, primary clinical site, or major 
participating institution for one or more programs as these terms are 
used in the most recent publication of the Graduate Medical Education 
Directory, or as the sponsor or is listed under ``affiliations and 
outside rotations'' for one or more programs in Opportunities, 
Directory of Osteopathic Post-Doctoral Education Programs; or (3) 
effective beginning July 1, 2003, two or more hospitals are under 
common ownership and have a shared rotational arrangement under Sec.  
413.79(f)(2). Form Number: CMS-10326 (OMB control number: 0938-1111); 
Frequency: Annually; Affected Public: Business or other For-profit and 
Not-for-profit institutions; Number of Respondents: 125; Total Annual 
Responses: 125; Total Annual Hours: 166. (For policy questions 
regarding this collection contact Renate Dombrowski at 410-786-4645.)
    3. Type of Information Collection Request: Reinstatement with 
change of a previouslyapproved collection; Title of Information 
Collection: Community Mental Health Center Cost Report; Use: Providers 
of services participating in the Medicare program are required under 
sections 1815(a) and 1861(v)(1)(A) of the Social Security Act (42 
U.S.C. 1395g) to submit annual information to achieve settlement of 
costs for health care services rendered to Medicare beneficiaries. In 
addition, regulations at 42 CFR 413.20 and 413.24 require adequate cost 
data and cost reports from providers on an annual basis. The Form CMS-
2088-17 cost report is needed to determine a provider's reasonable 
costs incurred in furnishing medical services to Medicare beneficiaries 
and reimbursement due to or due from a provider. The primary function 
of the cost report is to collect data that is used by CMS to support 
program operations, payment refinement activities and to make Medicare 
Trust Fund projections. Form Number: CMS-2088-17 (OMB control number: 
0938-0037); Frequency: Yearly; Affected Public: Private Sector 
(Business or other for-profits, Not-for-Profit Institutions); Number of 
Respondents: 219; Total Annual Responses: 219; Total Annual Hours: 
19,710. (For policy questions regarding this collection contact Jill 
Keplinger at 410-786-4550.)
    4. Type of Information Collection Request: Reinstatement without 
change of a previously approved collection; Title of Information 
Collection: CMS Enterprise Identity Management; Use: HIPAA regulations 
require covered entities to verify the identity of the person 
requesting Personal Health Information (PHI) and the person's authority 
to have access to that information. Per the HIPAA Security Rule, 
covered entities, regardless of their size, are required under 
Section164.312(a)(2)(i) to ``assign a unique name and/or number for 
identifying and tracking user identity.'' A `user' is defined in 
Section 164.304 as a ``person or entity with authorized access''. 
Accordingly, the Security Rule requires covered entities to assign a 
unique name and/or number to each employee or workforce member who uses 
a system that receives, maintains or transmits electronic PHI, so that 
system access and activity can be identified and tracked by user. This 
pertains to workforce members within health plans, group health plans, 
small or large provider offices, clearinghouses and beneficiaries. 
Federal law requires that CMS take precautions to minimize the security 
risk to the Federal information system. FIPS PUB 201--1 Para 1.2: 
``Homeland Security Presidential Directive 12 (HSPD 12), signed by the 
President on August 27, 2004, established the requirements for a common 
identification standard for the identification of credentials issued by 
Federal Departments and agencies to Federal employees and contractors 
(including contractor employees) for gaining physical access to 
Federally controlled facilities and logical access to Federally 
controlled information systems. HSPD 12 directs the department of 
Commerce to develop a Federal Information Processing Standards (FIPS) 
publication to define such a common identification credential.'' Form 
Number: CMS-10452 (OMB control number: 0938-1236); Frequency: Annually; 
Affected Public: Individuals and Households; Number of Respondents: 
750,000; Total Annual

[[Page 34677]]

Responses: 750,000; Total Annual Hours: 300,000. (For policy questions 
regarding this collection contact Robert Burger at 410-786-2125.)
    5. Type of Information Collection Request: Extension of a currently 
approved information collection; Title of Information Collection: 
Health Care Reform Insurance Web Portal Requirements 45 CFR part 159; 
Use: In accordance with the provisions of the ACA referenced above, the 
U.S. Department of Health and Human Services created a Web site called 
healthcare.gov to meet these and other provisions of the law, and data 
collection was conducted for six months based upon an emergency 
information collection request. The interim final rule published on May 
5, 2010 served as the emergency Federal Register notice for the prior 
information collection request. The Office of Management and Budget 
(OMB) reviewed the request under emergency processing and approved it 
on April 30, 2010.
    CMS updated the web portal system where state Departments of 
Insurance and issuers log in using a custom user ID and password 
validation. The states are asked to provide information on issuers in 
their state and various Web sites maintained for consumers. The issuers 
are also tasked with providing information on their major medical 
insurance products and plans. They are ultimately given the choice to 
download a basic information template to enter data then upload into 
the web portal; to manually enter data within the web portal itself; or 
to submit .xml files containing their information. Once the states and 
issuers submit their data, they will receive an email notifying them of 
any errors, and that their submission was received.
    CMS mandates that issuers verify and update their information on a 
quarterly basis and requests that States verify State-submitted 
information on an annual basis. In the event that an issuer enhances 
its existing plans, proposes new plans, or deactivates plans, the 
organization would be required to update the information in the web 
portal. Changes occurring during the three month quarterly periods will 
be allowed utilizing effective dates for both the plans and rates 
associated with the plans. Form Number: CMS-10320 (OMB control number: 
0938-1086); Frequency: Annually, Quarterly; Affected Public: State, 
Local, and Tribal Governments; Number of Respondents: 305; Total Annual 
Responses: 5,500; Total Annual Hours: 89,725. (For policy questions 
regarding this collection contact Kim Heckstall at 410-786-1647).
    6. Type of Information Collection Request: Revision of currently 
approved collection; Title of Information Collection: Annual MLR and 
Rebate Calculation Report and MLR Rebate Notices; Use: Under Section 
2718 of the Affordable Care Act and implementing regulation at 45 CFR 
part 158, a health insurance issuer (issuer) offering group or 
individual health insurance coverage must submit a report to the 
Secretary concerning the amount the issuer spends each year on claims, 
quality improvement expenses, non-claims costs, Federal and State taxes 
and licensing and regulatory fees, the amount of earned premium, and 
beginning with the 2014 reporting year, the amounts related to the 
reinsurance, risk corridors, and risk adjustment programs established 
under sections 1341, 1342, and 1343, respectively, of the Affordable 
Care Act. An issuer must provide an annual rebate if the amount it 
spends on certain costs compared to its premium revenue (excluding 
Federal and States taxes and licensing and regulatory fees) does not 
meet a certain ratio, referred to as the medical loss ratio (MLR). Each 
issuer is required to submit annually MLR data, including information 
about any rebates it must provide, on a form prescribed by CMS, for 
each State in which the issuer conducts business. Each issuer is also 
required to provide a rebate notice to each policyholder that is owed a 
rebate and each subscriber of policyholders that are owed a rebate for 
any given MLR reporting year. Additionally, each issuer is required to 
maintain for a period of seven years all documents, records and other 
evidence that support the data included in each issuer's annual report 
to the Secretary.
    Under Section 1342 of the Patient Protection and Affordable Care 
Act and implementing regulation at 45 CFR part 153, issuers of 
qualified health plans (QHPs) must participate in a risk corridors 
program. A QHP issuer will pay risk corridors charges or be eligible to 
receive payments based on the ratio of the issuer's allowable costs to 
the target amount. Each QHP issuer is required to submit an annual 
report to CMS concerning the issuer's allowable costs, allowable 
administrative costs, premium, and proportion of market premium in 
QHPs. Risk corridors premium information that is specific to an 
issuer's QHPs is collected through a separate plan-level data form, 
which is included in this information collection. Additionally, each 
QHP issuer is required to maintain for a period of ten years all 
documents, records and other evidence sufficient to enable the 
evaluation of the issuer's compliance with applicable risk corridors 
standards.
    On May 2, 2017, CMS published a 60-day notice in the Federal 
Register (82 FR 20481) for the public to submit written comments on 
this information collection; the public comment period closed on July 
3, 2017. As part of the 60-day notice, CMS updated its annual burden 
hour estimates to reflect the actual numbers of submissions, rebates 
and rebate notices.
    CMS received a total of six comments on a number of specific issues 
regarding the notice of the revised MLR PRA package. CMS has taken into 
consideration all of the comments and has modified the information 
collection instruments and instructions (the 2016 MLR Annual Reporting 
Form and Instructions; no comments were submitted on the 2016 Risk 
Corridors Plan-Level Data Form and Instructions) in order to correct 
errors and to provide additional clarifications. These modifications do 
not affect the previously estimated burden hours or costs. Form Number: 
CMS-10418 (OMB Control Number: 0938-1164); Frequency: Annually; 
Affected Public: Private Sector, Business or other for-profits and not-
for-profit institutions; Number of Respondents: 545; Number of 
Responses: 2,532; Total Annual Hours: 200,597. (For policy questions 
regarding this collection, contact Christina Whitefield at (301) 492-
4172.)

    Dated: July 21, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2017-15726 Filed 7-25-17; 8:45 am]
 BILLING CODE 4120-01-P