[Federal Register Volume 85, Number 217 (Monday, November 9, 2020)]
[Notices]
[Pages 71344-71346]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-24852]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10756, CMS-R-246]


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 January 8, 2021.

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.

[[Page 71345]]

    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-10576 Results of Your Drug Coverage Request
CMS-R-246 Medicare Advantage, Medicare Part D, and Medicare Fee-For-
Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) 
Survey

    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: New Collection (Request 
for a new OMB control number); Title of Information Collection: Results 
of Your Drug Coverage Request; Use: The purpose of this notice is to 
provide information to enrollees whenever a Medicare Advantage 
Prescription Drug plan (MA-PD) covers a prescription drug under a 
different Medicare benefit than was requested by the enrollee. The 
enrollee may request coverage under their Part B or Part D benefit. 
When the MA-PD approves coverage in the benefit that was not requested 
by the beneficiary, the determination involves both an approval and a 
denial of benefits. The plan must send written notification that is 
readable, understandable, and explains the specific reasons for the 
denial of the alternate benefit. The notice must also remind enrollees 
about their rights and protections related to requests for prescription 
drug coverage and include an explanation of both the standard and 
expedited redetermination processes and the rest of the appeal process.
    This collection replaces the current forms for communicating 
coverage provided to Medicare Advantage Prescription Drug (MA-PD) 
enrollees with regard to Part B vs. Part D drug requests. The new 
notice, Results of Your Drug Coverage Request, provides both approval 
messaging and the required denial messaging to beneficiaries in a more 
readable and understandable format than the existing Part D denial 
notice (CMS-10146, OMB-0938-0976) and Integrated Denial Notice (CMS-
10003, OMB-0938-0829). Currently, coverage for drugs that are subject 
to a Part B vs. Part D adjudication is communicated by two separate 
forms: CMS-10146 (OMB-0938-0976) (communicating denial under Part D) 
and CMS-10003 (OMB-0938-0829) (communicating denial under Part B).
    This proposed collection corrects this confusion by satisfying the 
denial and approval requirement in one form that brings focus to the 
approval rather than the denial. This proposed collection consolidates 
and streamlines the communication with enrollees by requiring one 
notice for communication when a drug request is subject to coordination 
of Part B and Part D benefits under 42 CFR 422.112. This collection is 
structured so that the enrollee receives a single notice that 
communicates both approval and denial under the respective benefits. 
Form Number: CMS-CMS-10756 (OMB control number: 0938-New); Frequency: 
Occasionally; Affected Public: Private Sector; Business or other for-
profit and not-for-profit institutions; Number of Respondents: 755; 
Total Annual Responses: 68,413; Total Annual Hours: 17,103. (For policy 
questions regarding this collection contact Trevor Rose at 410-786-
7768.)
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Medicare 
Advantage, Medicare Part D, and Medicare Fee-For-Service Consumer 
Assessment of Healthcare Providers and Systems (CAHPS) Survey; Use: The 
Centers for Medicare & Medicaid Services (CMS) has authority to collect 
various types of quality data under section 1852(e) of the Act and use 
this information to develop and publicly post a 5-star rating system 
for Medicare Advantage (MA) plans based on its authority to disseminate 
comparative information, including about quality, to beneficiaries 
under sections 1851(d) and 1860D-1(c) of the Act. As codified at Sec.  
422.152(b)(3), Medicare health plans are required to report on quality 
performance data which CMS can use to help beneficiaries compare plans. 
Cost plans under section 1876 of the Act are also included in the MA 
Star Rating system, as codified at Sec.  417.472(k), and are required 
by regulation (Sec.  417.472(j)) to make CAHPS survey data available to 
CMS.
    The MMA under Sec. 1860D-4 (Information to Facilitate Enrollment) 
requires CMS to conduct consumer satisfaction surveys of enrollees in 
MA and Part D contracts and report the results to Medicare 
beneficiaries prior to the annual enrollment period. This request for 
approval is for CMS to continue conducting the Medicare CAHPS surveys 
annually to meet the requirement to conduct consumer satisfaction 
surveys regarding the experiences of beneficiaries with their health 
and prescription drug plans.
    The primary purpose of the Medicare CAHPS surveys is to provide 
information to Medicare beneficiaries to help them make more informed 
choices among health and prescription drug plans available to them. 
Survey results are reported by CMS in the Medicare & You handbook 
published each fall and on the Medicare Plan Finder website. 
Beneficiaries can compare CAHPS scores for each health and drug plan as 
well as compare MA and FFS scores when making enrollment decisions. The 
Medicare CAHPS also provides data to help CMS and others monitor the 
quality and performance of Medicare health and prescription drug plans 
and identify areas to improve the quality of care and services provided 
to enrollees of these plans. CAHPS data are included in the Medicare 
Part C & D Star Ratings and used to calculate MA Quality Bonus 
Payments. Form Number: CMS-R-246 (OMB control number: 0938-0732);

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Frequency: Yearly; Affected Public: Private Sector; Business or other 
for-profit and not-for-profit institutions; Number of Respondents: 537; 
Total Annual Responses: 745,350; Total Annual Hours: 179,108. (For 
policy questions regarding this collection contact Sarah Gaillot at 
410-786-4637.)

    Dated: November 4, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2020-24852 Filed 11-6-20; 8:45 am]
BILLING CODE 4120-01-P