[Federal Register Volume 85, Number 194 (Tuesday, October 6, 2020)]
[Notices]
[Pages 63115-63116]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-22089]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10346, CMS-10142, 10123/10124]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, Health and Human 
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 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 7, 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. 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-10346 Appeals of Quality Bonus Payment Determinations
CMS-10142 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and 
Prescription Drug Plans (PDP)
CMS-10123/10124 Fast Track Appeals Notices: NOMNC/DENC

    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: 
Appeals of Quality Bonus Payment Determinations; Use: Section 1853(o) 
of the Social Security Act (the Act) requires CMS to make QBPs to MA 
organizations that achieve performance rating scores of at least 4 
stars under a five-star rating system. While CMS has applied a Star 
Rating system to MA organizations for a number of years, prior to the 
QBP

[[Page 63116]]

program these Star Ratings were used only to provide additional 
information for beneficiaries to consider in making their Part C and D 
plan elections. Additionally, section 1854(b)(1)(C)(v) of the Act, as 
added by the Affordable Care Act, also requires CMS to change the share 
of savings that MA organizations must provide to enrollees as the 
beneficiary rebate specified at Sec.  422.266(a) based on the level of 
a sponsor's Star Rating for quality performance.
    The information collected on the Request for Reconsideration form 
from MA organizations is considered by the reconsideration official and 
potentially the hearing officer to review CMS's determination of the 
organization's eligibility for a QBP. The form asks MA organizations to 
select the Star Ratings measure(s) they believe was miscalculated or 
used incorrect data and describe what they believe is the issue. Under 
Sec.  422.260(c)(3)(ii) these are the only bases for appeals. In 
conducting the reconsideration, the reconsideration official will 
review the QBP determination, the evidence and findings upon which it 
was based, and any other written evidence submitted by the organization 
with their Request for Reconsideration or by CMS before the 
reconsideration determination is made.
    The administrative review process is a two-step process that 
includes a request for reconsideration and a request for an informal 
hearing on the record after CMS has sent the MA organization the 
reconsideration decision. Both steps are conducted at the contract 
level. The first step allows the MA organization to request a 
reconsideration of how its Star Rating for the given measure in 
question was calculated and/or what data were included in the measure. 
If the MA organization is dissatisfied with CMS's reconsideration 
decision, the contract may request an informal hearing to be conducted 
by a hearing officer designated by CMS. MA organizations will have 10 
business days from the time we issue the notice of QBP status to submit 
a request for reconsideration. MA organizations will have 10 business 
days after the issuance of the reconsideration determination to request 
an informal hearing on the record. Form Number: CMS-10346 (OMB control 
number: 0938-1129); Frequency: Yearly; Affected Public: Private Sector, 
Business or other for-profits, Not-for-profit institutions; Number of 
Respondents: 20; Total Annual Responses: 20; Total Annual Hours: 160. 
(For policy questions regarding this collection contact Joy Binion at 
410-786-6567.)
    2. Type of Information Collection Request: Revision with change of 
a currently approved collection; Title of Information Collection: Bid 
Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription 
Drug Plans (PDP); Use: This collection dates back to 2005. Under the 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 
(MMA), and implementing regulations at 42 CFR, Medicare Advantage 
organizations (MAO) and Prescription Drug Plans (PDP) are required to 
submit an actuarial pricing ``bid'' for each plan offered to Medicare 
beneficiaries for approval by the Centers for Medicare & Medicaid 
Services (CMS). MAOs and PDPs use the Bid Pricing Tool (BPT) software 
to develop their actuarial pricing bid. The competitive bidding process 
defined by the ``The Medicare Prescription Drug, Improvement, and 
Modernization Act'' (MMA) applies to both the MA and Part D programs. 
It is an annual process that encompasses the release of the MA rate 
book in April, the bid's that plans submit to CMS in June, and the 
release of the Part D and RPPO benchmarks, which typically occurs in 
August. Form Number: CMS-10142 (OMB control number: 0938-0944); 
Frequency: Yearly; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 555; Total Annual Responses: 4,995; 
Total Annual Hours: 149,850. (For policy questions regarding this 
collection contact Rachel Shevland at 410-786-3026.)
    3. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Fast Track Appeals Notices: NOMNC/DENC; Use: The purpose of the NOMNC 
is to help a beneficiary/enrollee decide whether to pursue a fast 
appeal by a Quality Improvement Organization (QIO) and how to file that 
request. Consistent with Sec. Sec.  405.1200 and 422.624, SNFs, HHAs, 
CORFs, and hospices must provide notice to all beneficiaries/enrollees 
whose Medicare-covered services are ending, no later than two days in 
advance of the proposed termination of service. This information is 
conveyed to the beneficiary/enrollee via the NOMNC.
    If a beneficiary/enrollee appeals the termination decision, the 
beneficiary/enrollee and the QIO, consistent with Sec. Sec.  
405.1200(b) and 405.1202(f) for Original Medicare, and Sec. Sec.  
422.624(b) and 422.626(e)(1)-(5) for Medicare health plans, will 
receive a detailed explanation of the reasons services should end. This 
detailed explanation is provided to the beneficiary/enrollee using the 
DENC, the second notice included in this renewal package. Form Number: 
CMS-10123/10124 (OMB control number: 0938-0953); Frequency: Yearly; 
Affected Public: Private Sector, Business or other for-profits, Not-
for-profit institutions; Number of Respondents: 24,915; Total Annual 
Responses: 5,314,194; Total Annual Hours: 1,142,749. (For policy 
questions regarding this collection contact Janet Miller at 
[email protected].)

    Dated: October 1, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2020-22089 Filed 10-5-20; 8:45 am]
BILLING CODE 4120-01-P