[Federal Register Volume 84, Number 202 (Friday, October 18, 2019)]
[Notices]
[Pages 55966-55968]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-22718]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers CMS-10227, CMS-10243, CMS-10316 and CMS-10716]


Agency Information Collection Activities: Proposed Collection; 
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 (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 December 17, 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: 

[[Page 55967]]

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-10227 PACE State Plan Amendment Preprint
CMS-10243 Testing Experience and Functional Tools: Functional 
Assessment Standardized Items (FASI) Based on the CARE Tool
CMS-10316 Implementation of the Medicare Prescription Drug Plan (PDP) 
and Medicare Advantage (MA) Plan Disenrollment Reasons Survey
CMS-10716 Applicable Integrated Plan Coverage Decision Letter

    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: PACE State Plan 
Amendment Preprint; Use: If a state elects to offer PACE as an optional 
Medicaid benefit, it must complete a state plan amendment preprint 
packet described as ``Enclosures 3, 4, 5, 6, and 7.'' CMS will review 
the information provided in order to determine if the state has 
properly elected to cover PACE services as a state plan option. In the 
event that the state changes something in the state plan, only the 
affected page must be updated. Form Number: CMS-10227 (OMB control 
number: 0938-1027); Frequency: Once and occasionally; Affected Public: 
State, Local, or Tribal Governments; Number of Respondents: 7; Total 
Annual Responses: 2; Total Annual Hours: 140. (For policy questions 
regarding this collection contact Angela Cimino at 410-786-2638.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Testing 
Experience and Functional Tools: Functional Assessment Standardized 
Items (FASI) Based on the CARE Tool; Use: In 2012, CMS funded a project 
entitled, Technical Assistance to States for Testing Experience and 
Functional Tools (TEFT) Grants. One component of this demonstration is 
to amend and test the reliability of a setting-agnostic, interoperable 
set of data elements, called ``items,'' that can support standardized 
assessment of individuals across the continuum of care. Items that were 
created for use in post-acute care settings using the Continuity 
Assessment Record and Evaluation (CARE) tool have been adopted, 
modified, or supplemented for use in community-based long-term services 
and supports (CB-LTSS) programs. This project will test the reliability 
and validity of the function-related assessment items, now referred to 
as Functional Assessment Standardized Items (FASI), when applied in 
community settings, and in various populations: Elders (65 years and 
older); younger adults (18-64) with physical disabilities; and adults 
of any age with intellectual or developmental disabilities, with severe 
mental illness, or with traumatic brain injury.
    Individual-level data will be collected two times using the TEFT 
FASI Item Set. The first data collection effort will collect data that 
can be analyzed to evaluate the reliability and validity of the FASI 
items when used with the five waiver populations. Assessors will 
conduct functional assessments in client homes using the TEFT FASI Item 
Set. Changes may be recommended to individual TEFT FASI items, to be 
made prior to releasing the TEFT FASI items for use by the states. The 
FASI Field Test Report will be released to the public.
    The second data collection will be conducted by the states to 
demonstrate their use of the FASI data elements. The assessment data 
could be used by the states for multiple purposes. They may use the 
standardized items to determine individual eligibility for state 
programs, or to help determine levels of care within which people can 
receive services, or other purposes. In the second round of data 
collection, states will demonstrate their proposed uses, manage their 
FASI data collection and conduct their own analysis, to the extent they 
propose to do such tasks. The states have been funded under the 
demonstration grant to conduct the round 2 data collection and 
analysis. These states will submit reports to CMS describing their 
experience in the Round 2 data collection, including the items they 
collected, how they planned to use the data, and the types of 
challenges and successes they encountered in doing so. The reports may 
be used by CMS in their evaluation of the TEFT grants. Form Number: 
CMS-10243 (OMB control number: 0938-1037); Frequency: On occasion; 
Affected Public: Individuals and Households; Number of Respondents: 
5,650; Total Annual Responses: 5,650; Total Annual Hours: 2,825. (For 
policy questions regarding this collection contact Kerry Lida at 410-
786-4826.)
    3. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Implementation of 
the Medicare Prescription Drug Plan (PDP) and Medicare Advantage (MA) 
Plan Disenrollment Reasons Survey; Use: The Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (MMA) provides a requirement 
to collect and report performance data for Part D prescription drug 
plans. Specifically, the MMA under Sec. 1860D-4 (Information to 
Facilitate Enrollment) requires CMS to conduct consumer satisfaction 
surveys regarding the PDP and MA contracts pursuant to section 1860D-
4(d).
    The Centers for Medicare & Medicaid Services (CMS) developed the 
Disenrollment Survey to capture the reasons for disenrollment at a time 
that is as close as possible to the actual date of disenrollment. 
Through this survey, CMS seeks to: (1) Obtain information about 
beneficiaries' expectations relative to provided benefits and services 
(for both MA and PDPs) and (2) determine the reasons that prompt 
beneficiaries to voluntarily disenroll. It is important to include such 
information from disenrollees as CMS assesses plan performance, because 
plan disenrollment can be a broad indicator of beneficiary 
dissatisfaction with some aspect of plan services, such as access to 
care, customer service, cost, benefits provided, or quality of care. 
Information obtained from the Disenrollment Survey also supports the 
quality improvement efforts of individual plans and provides data to 
assist consumer choice through use of the Medicare Plan Finder website.
    The survey results are an important plan monitoring tool for CMS to 
ensure that Medicare beneficiaries are receiving high quality services 
from contracted providers. CMS uses information from the survey to 
track changes in the

[[Page 55968]]

reasons Medicare beneficiaries cite for disenrolling to monitor 
improvements/declines over time nationally and at the plan level. CMS 
also uses the disenrollment survey results to support the quality 
improvement efforts of individual plans, by providing plans with a 
detailed, annual report showing the reasons disenrollees cited for 
voluntarily leaving the plan and comparing the plan's scores to 
regional and national benchmarks. Additionally, CMS uses the plan-
specific results of the survey to provide Medicare beneficiaries with 
information (i.e., reasons cited for disenrolling from a plan and the 
frequency with which disenrollees cite each of the reasons) to assist 
beneficiaries with their annual consumer choice of plans. Form Number: 
CMS-10316 (OMB control number: 0938-1113); Frequency: Yearly; Affected 
Public: State, Local, or Tribal Governments; Number of Respondents: 
43,872; Total Annual Responses: 43,872; Total Annual Hours: 8,774. (For 
policy questions regarding this collection contact Beth Simon at 415-
744-3780.)
    4. Type of Information Collection Request: New Collection (Request 
for a new OMB control number); Title of Information Collection: 
Applicable Integrated Plan Coverage Decision Letter; Use: The 
Bipartisan Budget Act (BBA) of 2018 directed the establishment of 
procedures to unify Medicare and Medicaid grievance and appeals 
procedures to the extent feasible for dual eligible special needs plans 
(D-SNPs) beginning in 2021. On April 16, 2019, CMS finalized rules 
(hereafter referred to as the April 2019 final rule) to implement these 
new statutory provisions.[1] As a result of these regulations, starting 
in 2021, a subset of full integrated dual special needs plans (FIDE 
SNPs) and highly integrated dual special needs plans (HIDE SNPs) will 
need to unify and update appeals and grievance procedures, including 
how enrollees are notified of their appeal rights.
    Applicable integrated plans as defined at Sec.  422.561 are 
required to issue form CMS-10716 when a request for either a medical 
service or payment covered under the Medicare or Medicaid benefit is 
denied in whole or in part. The notice explains why the plan denied the 
service or payment and informs the plan enrollees of their appeal 
rights.
    The ``Applicable Integrated Plan Coverage Decision Letter'' or the 
``coverage decision letter'', which will be issued as a result of an 
integrated organization determination under 42 CFR 422.631 when an 
applicable integrated plan reduces, stops, suspends, or denies, in 
whole or in part, a request for a service/item (including a Part B 
drug) or a request for payment of a service/item (including a Part B 
drug) the member has already received. ``Applicable integrated plans,'' 
hereinafter referred to as ``plans'', are defined at 42 CFR 422.561 as 
FIDE SNPs or HIDE SNPs with exclusively aligned enrollment, where state 
policy limits the D-SNP's membership to a Medicaid managed care plan 
offered by the same organization. Applicable integrated plans will 
issue the coverage decision letter starting in CY 2021 in place of the 
Notice of Denial of Medical Coverage (or Payment) (NDMCP) form (CMS-
10003) as part of requirements to unify appeals and grievance 
processes. All other Medicare Advantage (MA) plans will continue to use 
the NDMCP form (CMS-10003). Form Number: CMS-10716 (OMB control number: 
0938-New); Frequency: Yearly; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 693; Total Annual Responses: 693; 
Total Annual Hours: 116. (For policy questions regarding this 
collection contact Marna Metcalf Akbar at 410-786-8251.)

    Dated: October 11, 2019.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2019-22718 Filed 10-17-19; 8:45 am]
 BILLING CODE 4120-01-P