[Federal Register Volume 85, Number 67 (Tuesday, April 7, 2020)]
[Notices]
[Pages 19487-19489]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-07185]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10636 and CMS-10592]


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

[[Page 19488]]

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 June 8, 2020.

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-10636 Triennial Network Adequacy Review for Medicare Advantage 
Organizations and 1876 Cost Plans
CMS-10592 Establishment of Exchanges and Qualified Health Plans; 
Exchange Standards for Employers

    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 with change of 
a currently approved collection; Title of Information Collection: 
Triennial Network Adequacy Review for Medicare Advantage Organizations 
and 1876 Cost Plans; Use: CMS regulations at 42 CFR 417.414, 417.416, 
422.112(a)(1)(i), and 422.114(a)(3)(ii) require that all Medicare 
Advantage organizations (MAOs) offering coordinated care plans, 
network-based private fee-for-service (PFFS) plans, and as well as 
section 1876 cost organizations, maintain a network of appropriate 
providers that is sufficient to provide adequate access to covered 
services to meet the needs of the population served. To enforce this 
requirement, CMS developed network adequacy criteria which set forth 
the minimum number of providers and maximum travel time and distance 
from enrollees to providers, for required provider specialty types in 
each county in the United States and its territories. Organizations 
must be in compliance with the current CMS network adequacy criteria 
guidance, which is updated and published annually on CMS's website. 
Additional network policy guidance is also located in chapter 4 of the 
Medicare Managed Care Manual. This collection of information is 
essential to appropriate and timely compliance monitoring by CMS, in 
order to ensure that all active contracts offering network-based plans 
maintain an adequate network.
    CMS verifies that organizations are compliant with the CMS network 
adequacy criteria by performing a contract-level network review, which 
occurs when CMS requests an organization upload provider and facility 
Health Service Delivery (HSD) tables for a given contract to the Health 
Plan Management System (HPMS). CMS reviews networks on a three-year 
cycle, unless there is an event that triggers an intermediate full 
network review, thus resetting the organization's triennial review. The 
triennial review cycle will help ensure a consistent process for 
network oversight and monitoring.
    Once CMS staff reviews the ACC reports and any Exception Requests 
and/or Partial County Justifications, CMS then makes its final 
determination on whether the organization is operating in compliance 
with current CMS network adequacy criteria. If the organization passes 
its network review for a given contract, then CMS will take no further 
action. If the organization fails its network review for a given 
contract, then CMS will take appropriate compliance actions. CMS has 
developed a compliance methodology for network adequacy reviews that 
will ensure a consistent approach across all organizations. Form 
Number: CMS-10636 (OMB control number: 0938-1346); Frequency: Yearly; 
Affected Public: Private Sector, Business or other for-profits; Number 
of Respondents: 140; Total Annual Responses: 1,416; Total Annual Hours: 
12,772. (For policy questions regarding this collection contact Amber 
Casserly at 410-786-5530.)
    2. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Establishment of Exchanges and Qualified Health Plans; Exchange 
Standards for Employers; Use: Section 1321(a) requires HHS to issue 
regulations setting standards for meeting the requirements under Title 
I of the Affordable Care Act including the offering of Qualified Health 
Plans (QHPs) through the Exchanges. On March 27, 2012, HHS published 
the rule CMS-9989-F: Establishment of Exchanges and Qualified Health 
Plans; Exchange Standards for Employers. The Exchange rule contains 
provisions that

[[Page 19489]]

mandate reporting and data collections necessary to ensure that health 
insurance issuers are meeting the requirements of the Affordable Care 
Act. These information collection requirements are set forth in 45 CFR 
part 156.
    Information collected by the Exchanges or Medicaid and CHIP 
agencies will be used to determine eligibility for coverage through the 
Exchange and insurance affordability programs (i.e., Medicaid, CHIP, 
and advance payment of the premium tax credits); evaluate how CMS can 
best communicate eligibility and enrollment updates to issuers; and 
assist consumers in enrolling in a QHP if eligible. Applicants include 
anyone who may be eligible for coverage through any of these programs. 
Form Number: CMS-10592 (OMB control number: 0938-1341); Frequency: 
Annually, Monthly, Occasionally; Affected Public: Private Sector: 
Business or other for-profits; Number of Respondents: 250; Total Annual 
Responses: 250; Total Annual Hours: 131,750. (For policy questions 
regarding this collection contact Anne Pesto at 443-844-9966.)

    Dated: April 1, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2020-07185 Filed 4-6-20; 8:45 am]
BILLING CODE 4120-01-P