[Federal Register Volume 84, Number 186 (Wednesday, September 25, 2019)]
[Notices]
[Pages 50453-50455]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-20858]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10062, CMS-10344 and CMS-588]


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

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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 November 25, 2019.

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' website address at website 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 N. 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-10062 Collection of Diagnostic Data in the Abbreviated RAPS Format 
from Medicare Advantage Organizations for Risk Adjusted Payments
CMS-10344 Elimination of Cost-Sharing for full benefit dual-eligible 
Individuals Receiving Home and Community-Based Services
CMS-588 Electronic Funds Transfer Authorization Agreement

    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: Extension without change 
of a currently approved collection; Title of Information Collection: 
Collection of Diagnostic Data in the Abbreviated RAPS Format from 
Medicare Advantage Organizations for Risk Adjusted Payments; Use: The 
1997 BBA and later legislation required CMS to adjust per-beneficiary 
payments with a risk adjustment methodology using diagnoses to measure 
relative risk due to health status instead of just demographic 
characteristics such as age, sex, and Medicaid eligibility. The purpose 
of risk adjustment is to pay plan sponsors accurately based on the 
health status and diagnoses of their Medicare enrollees. Risk 
adjustment using diagnoses provides more accurate payments for Medicare 
Advantage Organizations (MAO), with higher payments for enrollees at 
risk for being sicker, and lower payments for enrollees predicted to be 
healthier.
    The BBA constituted the first legislative mandate for health status 
risk adjustment. Section 1853 (a)(3) of the Social Security Act as 
enacted by Section 4001 of Subtitle A of the BBA required the Secretary 
to implement a risk adjustment methodology that accounted for 
variations in per capita costs based on health status and other 
demographic factors for payment to Medicare+Choice (now MA) 
organizations. The new methodology was to be effective no later than 
January 1, 2000. The BBA also required that M+C organizations submit 
data for use in developing risk adjusted payments.
    Risk adjustment allows CMS to pay plans for the health risk of the 
beneficiaries they enroll, instead of paying an identical an average 
amount for each enrollee Medicare beneficiaries. By risk adjusting plan 
payments, CMS is able to make appropriate and accurate payments for 
enrollees with differences in expected costs. Risk adjustment is used 
to adjust bidding and payment based on the health status and 
demographic characteristics of an enrollee. Risk scores measure 
individual beneficiaries' relative risk and the risk scores are used to 
adjust payments for each beneficiary's expected expenditures. By risk 
adjusting plan bids, CMS is able to also use standardized bids as base 
payments to plans.
    CMS' fundamental goal for the abbreviate format RAPS data is to 
require collection of the minimum data necessary for accurate risk-
adjusted payment. We believe that diagnostic data provide the most 
reliable approach to measuring health status, as required by statute. 
In the absence of these data, we would not be able to accurately 
determine the beneficiary's health (risk) status. Form Number: CMS-
10062 (OMB control number: 0938-0878); Frequency: Quarterly; Affected 
Public: State, Local, or Tribal Governments; Number of Respondents: 
761; Total Annual Responses: 46,610,448; Total Annual Hours: 33,484. 
(For policy questions regarding this collection contact Michael P. 
Massimini at 410-786-1566.)
    2. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Elimination of Cost-Sharing for full benefit dual-eligible Individuals 
Receiving Home and Community-Based Services; Use: Each month CMS deems 
individuals automatically eligible for the full subsidy, based on data 
from State Medicaid Agencies and the Social Security Administration 
(SSA). The SSA sends a monthly file of Supplementary Security Income-
eligible beneficiaries to CMS. Similarly, the State Medicaid agencies 
submit Medicare Modernization Act files to CMS that identify full 
subsidy beneficiaries. CMS deems the beneficiaries as having full 
subsidy and auto-assigns these beneficiaries to bench mark Part D 
plans. Part D plans receive premium amounts based on the monthly 
assessments.

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    State MMA Phase Down (SPD) exchange enables CMS to implement the 
Medicare Prescription Drug, Improvement, and Modernization Act, also 
called the Medicare Modernization Act (MMA), which was enacted into law 
in 2003. This data exchange allows the State Medicaid Agency (SMA) to 
identify Medicare beneficiaries with coverage under the Medicaid 
program. The SMAs also identify other low-income Medicare beneficiaries 
who have applied for the Part D Low-Income Subsidy (LIS). As a result 
of the identification of these two groups of beneficiaries, CMS auto-
assigns and/or facilitates enrollment of the appropriate beneficiaries 
into Part D plans.
    Section 1860 D-14 of the Social Security Act sets forth 
requirements for premium and cost-sharing subsidies for low-income 
beneficiaries enrolled in Medicare Part D. Based on this statute, 42 
CFR 423.771, provides guidance concerning limitations for payments made 
by and on behalf of low-income Medicare beneficiaries who enroll in 
Part D plans. 42 CFR 423.771 (b) establishes requirements for 
determining a beneficiary's eligibility for full subsidy under the Part 
D program. Regulations set forth in 423.780 and 423.782 outline premium 
and cost sharing subsidies to which full subsidy eligible are entitled 
under the Part D program. Form Number: CMS-10344 (OMB control number: 
0938-1127); Frequency: Monthly; Affected Public: State, Local, or 
Tribal Governments; Number of Respondents: 51; Total Annual Responses: 
612; Total Annual Hours: 612. (For policy questions regarding this 
collection contact Roland Horrea at 410-786-0668.)
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Electronic Funds 
Transfer Authorization Agreement; Use: Section 1815(a) of the Social 
Security Act provides the authority for the Secretary of Health and 
Human Services to pay providers/suppliers of Medicare services at such 
time or times as the Secretary determines appropriate (but no less 
frequently than monthly). Under Medicare, CMS, acting for the 
Secretary, contracts with Fiscal Intermediaries and Carriers to pay 
claims submitted by providers/suppliers who furnish services to 
Medicare beneficiaries. Under CMS' payment policy, Medicare providers/
suppliers have the option of receiving payments electronically. Form 
Number: CMS-588 (OMB control number: 0938-0626); Frequency: On 
occasion; Affected Public: Business or other for-profit and Not-for-
profit institutions; Number of Respondents: 100,000; Total Annual 
Responses: 100,000; Total Annual Hours: 100,000. For questions 
regarding this collection contact Kim McPhillips at 410-786-5374.

    Dated: September 20, 2019.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2019-20858 Filed 9-24-19; 8:45 am]
 BILLING CODE 4120-01-P