[Federal Register Volume 86, Number 196 (Thursday, October 14, 2021)]
[Notices]
[Pages 57149-57151]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-22448]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-222-17, CMS-10142 and CMS-10552]


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.

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DATES: Comments must be received by December 13, 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.
    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.

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-222-17 Independent Rural Health Clinic Cost Report
CMS-10142 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and 
Prescription Drug Plans (PDP)
CMS-10552 Implementation of Medicare and Medicaid Programs;--Promoting 
Interoperability Programs (Stage 3) (CMS-10552)

    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: Reinstatement without 
change of a previously approved collection; Title of Information 
Collection: Independent Rural Health Clinic Cost Report; Use: Under the 
authority of sections 1815(a) and 1833(e) of the Social Security Act 
(42 U.S.C. 1395g), CMS requires that providers of services 
participating in the Medicare program submit information to determine 
costs for health care services rendered to Medicare beneficiaries. CMS 
requires that providers follow reasonable cost principles under 
1861(v)(1)(A) of the Act when completing the Medicare cost report. 
Regulations at 42 CFR 413.20 and 413.24 require that providers submit 
acceptable cost reports on an annual basis and maintain sufficient 
financial records and statistical data, capable of verification by 
qualified auditors.
    CMS requires Form CMS-222-17 to determine an RHC's reasonable costs 
incurred in furnishing medical services to Medicare beneficiaries and 
reimbursement due to or from an RHC. Each RHC submits the cost report 
to its contractor for a reimbursement determination. Section 1874A of 
the Act describes the functions of the contractor.
    CMS regulations at 42 CFR 413.24(f)(4)(ii) requires that each RHC 
submit an annual cost report to their contractor in American Standard 
Code for Information Interchange (ASCII) electronic cost report (ECR) 
format. RHCs submit the ECR file to contractors using a compact disk 
(CD), flash drive, or the CMS approved Medicare Cost Report E-filing 
(MCREF) portal, [URL: https://mcref.cms.gov]. Form Number: CMS-222-17 
(OMB control number: 0938-0107); Frequency: Yearly; Affected Public: 
Private Sector, State, Local, or Tribal Governments, Federal 
Government, Business or other for-profits, Not-for-profits 
institutions; Number of Respondents: 1,724; Total Annual Responses: 
1,724; Total Annual Hours: 94,820. (For policy questions regarding this 
collection contact LuAnn Piccione at (410) 786-5423.
    2. Type of Information Collection Request: Extension without 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: Revision of a currently 
approved collection; Title of Information Collection: Implementation of 
Medicare and Medicaid Programs;--Promoting Interoperability Programs 
(Stage 3) (CMS-10552); Use: As discussed in the Final Rule published on 
October 16, 2016 (80 FR 62762), the Centers for Medicare & Medicaid 
Services (CMS) is requesting approval to collect information from 
eligible hospitals and critical access hospitals (CAHs). We are making 
further changes to this program as proposed in the FY 2022 Inpatient 
Prospective Payment System (IPPS)/Long-term Care Hospital Prospective 
Payment System (LTCH PPS) Proposed Rule (86 FR 25628), and as finalized 
in the FY 2022 Inpatient Prospective Payment System (IPPS)/Long-term 
Care Hospital Prospective Payment System (LTCH PPS) Final Rule (86 FR 
45460).
    The American Recovery and Reinvestment Act of 2009 (Recovery Act) 
(Pub. L. 111-5) was enacted on February 17, 2009. Title IV of Division 
B of the Recovery Act amended Titles XVIII and XIX of the Social 
Security Act (the Act) by establishing incentive payments to eligible 
professionals (EPs),

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eligible hospitals and critical access hospitals (CAHs), and Medicare 
Advantage (MA) organizations participating in the Medicare and Medicaid 
programs that adopt and successfully demonstrate meaningful use of 
certified EHR technology (CEHRT). These Recovery Act provisions, 
together with Title XIII of Division A of the Recovery Act, may be 
cited as the ``Health Information Technology for Economic and Clinical 
Health Act'' or the ``HITECH Act.''
    The HITECH Act created incentive programs for EPs and eligible 
hospitals, including CAHs, in the Medicare Fee-for-Service (FFS), MA, 
and Medicaid programs that successfully demonstrate meaningful use of 
certified EHR technology. In their first payment year, Medicaid EPs and 
eligible hospitals could adopt, implement, or upgrade to certified EHR 
technology. It also allowed for negative payment adjustments in the 
Medicare FFS and MA programs starting in 2015 for EPs, eligible 
hospitals, and CAHs participating in Medicare that are not meaningful 
users of CEHRT. The Medicaid Promoting Interoperability Program did not 
authorize negative payment adjustments, but its participants were 
eligible for positive incentive payments.
    In CY 2017, we began collecting data from eligible hospitals and 
CAHs to determine the application of the Medicare payment adjustments. 
At this time, Medicare eligible professionals no longer reported to the 
EHR Incentive Program, as they began reporting under the Merit-based 
Incentive Payment System (MIPS). This information collected was also 
used to make incentive payments to eligible hospitals and critical 
access hospitals in Puerto Rico.
    In the FY 2019 IPPS/LTCH PPS Final Rule (83 FR 41634), we focused 
on reducing burden on eligible hospitals and CAHs. We finalized a new 
scoring methodology for eligible hospitals and CAHs, removing the 
requirement to report on and meet the threshold for all objectives and 
measures. This approach required an eligible hospital or CAH to meet 
the requirements on six measures, with scoring based on performance. 
This approach reduced burden by decreasing the amount of time needed to 
report on measures. Additionally, we finalized two new optional opioid 
measures and one new care coordination measure to help address the 
opioid epidemic and improve interoperability.
    In the FY 2020 IPPS/LTCH Final Rule (84 FR 42591), we established 
the EHR Reporting Period to be a minimum of any continuous 90-day 
period in CY 2021 for new and returning participants (eligible 
hospitals and CAHs) in the Medicare Promoting Interoperability Program 
attesting to CMS, as well as finalizing the removal of the Electronic 
Prescribing Objective's Verify Opioid Treatment Agreement measure 
beginning with the EHR reporting period in CY 2020.
    In the FY 2021 IPPS/LTCH PPS Final Rule (85 FR 58966), we are 
finalizing as proposed changes that we believe will continue to be a 
low reporting burden on eligible hospitals and CAHs in the Medicare 
Promoting Interoperability Program while incentivizing the advanced use 
of CEHRT to support health information exchange, interoperability, 
advanced quality measurement, and maximizing clinical effectiveness and 
efficiencies. These finalized changes include continuing an EHR 
reporting period of a minimum of any continuous 90-day period in CY 
2022, and maintaining the Query of PDMP measure as optional and worth 5 
bonus points in CY 2021.
    In the FY 2022 IPPS/LTCH PPS Proposed Rule (86 FR 25628), we 
proposed changes that we believe will continue to be a low reporting 
burden on eligible hospitals and CAHs in the Medicare Promoting 
Interoperability Program while incentivizing the advanced use of CEHRT 
to support health information exchange, interoperability, advance 
quality measurement, and maximize clinical effectiveness and 
efficiencies. The proposals include continuing an EHR reporting period 
of a minimum of any continuous 90-day period in CY 2023, maintaining 
the Query of PDMP measure as optional but worth 10 bonus points in CY 
2022, the addition of a new Health Information Exchange Bi-Directional 
Exchange measure beginning in CY 2022 as an optional alternative to the 
two existing measures, a requirement of reporting 4 specific Public 
Health and Clinical Data Exchange Objective measures, the inclusion of 
a new SAFER Guides measure attestation response, and to adopt two new 
eCQMs to the Medicare Promoting Interoperability Program's eCQM measure 
set beginning with the reporting period in CY 2023 (in addition to 
removing three eCQMs from the measure set beginning with the reporting 
period in CY 2024, in alignment with the finalized changes to the 
Hospital IQR Program. In the FY 2022 IPPS/LTCH PPS Final Rule (86 FR 
45460 through 45498), we finalized these proposals. We did not finalize 
a proposal to update the Provide Patients Electronic Access to their 
Health Information measure to include a data retention requirement; 
however, this proposal would not have affected our information 
collection burden estimate.
    We note the previously approved PRA package under OMB control 
number 0938-1278 reflecting updates to information collection burden 
estimates based on policies finalized in the FY 2021 IPPS/LTCH PPS 
Final Rule include information collection burden estimates for 2021, 
which is the last year for including Medicaid eligible providers, 
eligible hospitals, and CAHs in the burden estimate as the Medicaid 
Promoting Interoperability Program concludes December 31, 2021. 
Therefore, this PRA request for information collection burden in 2022 
does not include any burden under the Medicaid Promoting 
Interoperability Program. Form Number: CMS-10552 (OMB control number: 
0938-1278); Frequency: Annually; Affected Public: State, Local or 
Private Government; Business and for-profit and Not-for-profit; Number 
of Respondents: 3,300; Total Annual Responses: 3,300; Total Annual 
Hours: 21,450. For policy questions regarding this collection, contact 
Jessica Warren at 410-786-7519.)

    Dated: October 8, 2021.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2021-22448 Filed 10-13-21; 8:45 am]
BILLING CODE 4120-01-P