[Federal Register Volume 85, Number 73 (Wednesday, April 15, 2020)]
[Notices]
[Pages 21009-21010]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-07884]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-10716 and CMS-R-262]


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 15, 2020.

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:
    Written comments and recommendations for the proposed information 
collection should be sent within 30 days of publication of this notice 
to www.reginfo.gov/public/do/PRAMain. Find this particular information 
collection by selecting ``Currently under 30-day Review--Open for 
Public Comments'' or by using the search function.
    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 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: New Collection; Title of 
Information Collection: Applicable

[[Page 21010]]

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.)
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: CMS Plan Benefit 
Package (PBP) and Formulary CY 2021; Use: This information is mandated 
by the Social Security Act in order to collect plan bids that will 
establish the Medicare Advantage (Part C) and Prescription Drug (Part 
D) plan benefit package options to be offered to Medicare beneficiaries 
during the next annual open enrollment period. The Part C bid deadline 
(the first Monday in June) is stated at Section 1854(a)(6)(A) of the 
Social Security Act. The same deadline is applied to Part D bids by 
reference to the Part C requirement at Section 1860D-11(b)(1) of the 
Act and is cited in the 42 CFR references listed above. Copies of these 
references are provided in Appendix D. Section 6062 of the SUPPORT Act 
amended section 1860D-4(e)(2) of the Act to require the adoption of 
transaction standards for the Part D e-prescribing program to ensure 
secure ePA request and response transactions between prescribers and 
Part D plan sponsors no later than January 1, 2021. Form Number: CMS-R-
262 (OMB control number: 0938-0763); Frequency: Yearly; Affected 
Public: Private sector (Business or other for-profits and Not-for-
profits institutions); Number of Respondents: 774; Total Annual 
Responses: 9,201; Total Annual Hours: 77,343. (For policy questions 
regarding this collection contact Joella Roland at 410-786-7638.)

    Dated: April 9, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2020-07884 Filed 4-14-20; 8:45 am]
BILLING CODE 4120-01-P