[Federal Register Volume 84, Number 73 (Tuesday, April 16, 2019)]
[Notices]
[Pages 15615-15616]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-07581]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10330, CMS-276, and CMS-906]


Agency Information Collection Activities: Submission for OMB 
Review; 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 (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 May 16, 2019.

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' website address at website address at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
    1. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to [email protected].
    2. 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. 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. 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: Extension of a currently 
approved collection; Title of Information Collection: Enrollment 
Opportunity Notice Relating to Lifetime Limits; Required Notice of 
Rescission of Coverage; and Disclosure Requirements for Patient 
Protection under the Affordable Care Act; Use: Sections 2712 and 2719A 
of the Public Health Service Act, as added by the Affordable Care Act, 
and the interim final regulations titled ``Patient Protection and 
Affordable Care Act: Preexisting Condition Exclusions, Lifetime and 
Annual Limits, Rescissions, and Patient Protections'' (75 FR 37188, 
June 28, 2010) contain rescission notice, and patient protection 
disclosure requirements that are subject to the Paperwork Reduction Act 
of 1995. The rescission notice will be used by health plans to provide 
advance notice to certain individuals that their coverage may be 
rescinded as a result of fraud or intentional misrepresentation of 
material fact. The patient protection notification will be used by 
health plans to inform certain individuals of their right to choose a 
primary care provider or pediatrician and to use obstetrical/
gynecological services without prior authorization. The related 
provisions are finalized in the final regulations titled ``Final Rules 
under the Affordable Care Act for Grandfathered Plans, Preexisting 
Condition Exclusions, Lifetime and Annual Limits, Rescissions, 
Dependent Coverage, Appeals, and Patient Protections''. The final 
regulations also require that, if State law prohibits balance billing, 
or a plan or issuer is contractually responsible for any amounts 
balanced billed by an out-of-network emergency services provider, a 
plan or issuer must provide a participant, beneficiary or enrollee 
adequate and prominent notice of their lack of financial responsibility 
with respect to amounts balanced billed in order to prevent inadvertent 
payment by the individual. Form Number: CMS-10330 (OMB Control Number: 
0938-1094); Frequency: Occasionally; Affected Public: Private Sector, 
State, Local, or Tribal Governments; Number of Respondents: 920; Number 
of Responses: 71,268; Total Annual Hours: 524. (For policy questions 
regarding this collection contact Usree Bandyopadhyay at 410-786-6650.)
    2. Type of Information Collection Request: Revision of a currently 
approved information collection; Title of Information Collection: 
Prepaid Health Plan Cost Report; Use: Health Maintenance Organizations 
and Competitive Medical Plans (HMO/CMPs) contracting with the Secretary 
under Section 1876 of the Social Security Act are required to submit a 
budget and enrollment forecast, semi-annual interim report, 4th Quarter 
interim report (CMS has waived this annual submission), and a final 
certified cost report in accordance with 42 CFR 417.572-417.576. The 
submission, receipt and processing of the cost reports is imperative to 
determine if MCOs are paid on a reasonable basis for the covered 
services furnished to Medicare enrollees. CMS reviews the data 
submitted within the cost reports to establish monthly payment rates, 
monitor interim rates, and determine the final reimbursement. Health 
Care Prepayment Plans (HCPPs) contracting with the Secretary under 
Section 1833 of the Social Security Act are required to submit a budget 
and enrollment forecast, semi-annual interim report, and final cost 
report in accordance with 42 CFR 417.808 and 42 CFR 417.810. Form 
Number: CMS-276 (OMB control number: 0938-0165); Frequency: Quarterly; 
Affected Public: Businesses or other for-profits, Not-for-profit 
institutions; Number of Respondents: 57; Total Annual Responses: 67; 
Total Annual Hours: 1,800. (For policy

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questions regarding this collection, contact Bilal Farrakh at 410-786-
4456.)
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: The Fiscal 
Soundness Reporting Requirements; Use: All contracting organizations 
must submit audited annual financial statements one time per year. In 
addition, to the audited annual submission, Health Plans with a 
negative net worth and/or a net loss and the amount of that loss is 
greater than one-half of the organization's total net worth must file 
quarterly financial statements for fiscal soundness monitoring. Part D 
organizations are required to submit three (3) quarterly financial 
statements. Lastly, PACE organizations are required to file four (4) 
quarterly financial statements for the first three (3) years in the 
program. After the first three (3) years, PACE organizations with a 
negative net worth and/or a net loss and the amount of that loss is 
greater than one-half of the organization's total net worth must submit 
quarterly financial statements for fiscal soundness monitoring. CMS is 
responsible for overseeing the ongoing financial performance for all 
Medicare Health Plans, PDPs, and PACE organizations. Specifically, CMS 
needs the requested information collected in order to establish that 
contracting entities within those programs maintain fiscally sound 
operations. Form Number: CMS-906 (OMB control number: 0938-0469); 
Frequency: Yearly; Affected Public: Business or other for-profits, Not-
for profits institutions; Number of Respondents: 767; Total Annual 
Responses: 1589; Total Annual Hours: 530. (For policy questions 
regarding this collection contact Christa Zalewski at 410-786-1971.)

    Dated: April 11, 2019.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2019-07581 Filed 4-15-19; 8:45 am]
 BILLING CODE 4120-01-P