[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