[Federal Register Volume 87, Number 213 (Friday, November 4, 2022)]
[Notices]
[Pages 66709-66711]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-24098]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-10003, CMS-1771, CMS-10789 and CMS-10379]


Agency Information Collection Activities: Submission for OMB 
Review; 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 (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 December 5, 2022.

ADDRESSES: 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, please access 
the CMS PRA website by copying and pasting the following web address 
into your web browser: https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.

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: Extension of a currently 
approved collection; Title: Notice of Denial of Medical Coverage (or 
Payment); Use: Section 1852(g)(1)(B) of the Social Security Act (the 
Act) requires Medicare health plans to provide enrollees with a written 
notice in understandable language of the reasons for the denial and a 
description of the applicable appeals processes.

[[Page 66710]]

    Medicare health plans, including Medicare Advantage plans, cost 
plans, and Health Care Prepayment Plans (HCPPs), are required to issue 
the Notice of Denial of Medical Coverage (or Payment) (NDMCP) when a 
request for either a medical service or payment is denied, in whole or 
in part. Additionally, the notices inform Medicare enrollees of their 
right to file an appeal, outlining the steps and timeframes for filing. 
All Medicare health plans are required to use these standardized 
notices. Form Number: CMS-10003 (OMB Control Number: 0938-0829); 
Frequency: Annually; Affected Public: Private Sector, Business or other 
for-profit and not-for-profit institutions; Number of Respondents: 937; 
Number of Responses: 16,191,812; Total Annual Hours: 2,697,556. (For 
policy questions regarding this collection contact Sabrina Edmonston at 
410-786-3209.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title: Emergency and Foreign Hospital Services and 
Supporting Regulation in 42 CFR Section 424.103; Use: Section 1866 of 
the Social Security Act states that any provider of services shall be 
qualified to participate in the Medicare program and shall be eligible 
for payments under Medicare if it files an agreement with the Secretary 
to meet the conditions outlined in this section of the Act. Section 
1814(d)(1) of the Social Security Act and 42 CFR 424.100, allows 
payment of Medicare benefits for a Medicare beneficiary to a 
nonparticipating hospital that does not have an agreement in effect 
with the Centers for Medicare and Medicaid Services. These payments can 
be made if such services were emergency services and if CMS would be 
required to make the payment if the hospital had an agreement in effect 
and met the conditions of payment. This form is used in connection with 
claims for emergency hospital services provided by hospitals that do 
not have an agreement in effect under Section 1866 of the Social 
Security Act.
    42 CFR 424.103 (b) requires that before a non-participating 
hospital may be paid for emergency services rendered to a Medicare 
beneficiary, a statement must be submitted that is sufficiently 
comprehensive to support that an emergency existed. Form CMS- 1771 
contains a series of questions relating to the medical necessity of the 
emergency. The attending physician must attest that the hospitalization 
was required under the regulatory emergency definition (42 CFR 424.101 
attached) and give clinical documentation to support the claim. A 
photocopy of the beneficiary's hospital records may be used in lieu of 
the CMS-1771 if the records contain all the information required by the 
form.; Form Number: CMS-1771 (OMB Control Number: 0938-0023); 
Frequency: Annually; Affected Public: Private Sector, Business or other 
for-profit and not-for-profit institutions; Number of Respondents: 100; 
Number of Responses: 200; Total Annual Hours: 50. (For policy questions 
regarding this collection contact Shauntari Cheely at 410-786-1818.)
    3. Type of Information Collection Request: New Collection; Title of 
Information Collection: Customer Satisfaction Survey for Enterprise 
Portal Services (EPS) Users; Use: This EPS customer satisfaction survey 
will support EADG's goal of promoting improvements in the quality of 
EPS for all end-users and business owners. The collection of this 
information is necessary to enable EADG to obtain feedback in an 
efficient, timely manner, in accordance to our commitment to improving 
the quality and usability of our system. It will also allow for 
ongoing, collaborative, and actionable communications between EADG and 
all customers, stakeholders, and end-users.
    The goal of this Generic clearance and its survey is to capture 
feedback from actual users of the system immediately after they finish 
using the system, while their user experience, negative or positive, is 
still fresh in their minds. This user feedback will allow our team to 
discover areas of improvement within EPS. It will help us improve the 
user experience, provide better service/support, improve marketing 
strategies, and identify gaps/issues that require resolution. For 
example, if we get several responses through the collection instrument 
stating that users feel that the EPS system is slow, we can use that 
feedback to invest efforts into increasing the EPS response times. As 
the feedback is analyzed and implemented over time, the survey 
questions will evolve to support implemented changes, providing the EPS 
team with the most up-to-date feedback on system improvement.
    By using a Generic Instrument Collection, the survey will evolve 
over time. Within the CMS EPS, features are frequently added, and 
sometimes even removed. The team needs to be able to add new survey 
questions, specific to those new features, in order to capture valuable 
feedback on the effectiveness, ease-of-use, pain points, and areas of 
improvement for the 2 feature. When features are removed from the CMS 
EPS, questions relevant to those features must be modified or removed 
from the survey as well. In general, given that the CMS EPS is a 
dynamic system, designed to meet enterprise needs that change over 
time, a Generic Instrument Collection will allow the survey to evolve 
as the system evolves, and remain relevant, capturing up-to-date 
feedback on the system. Form Number: CMS-10789 (OMB control number: 
0938-New); Frequency: Quarter; Affected Public: Individuals and 
Households, Private Sector (Business or other for-profits, Not-for-
Profit Institutions); Number of Respondents: 300,000; Total Annual 
Responses: 360,000; Total Annual Hours: 90,000. (For policy questions 
regarding this collection contact Corey L. Redden at 410-279-5152.)
    4. Type of Information Collection Request: Revision of a previously 
approved information collection; Title of Information Collection: Rate 
Increase Disclosure and Review Reporting Requirements; Use: 45 CFR part 
154 implements the annual review of unreasonable increases in premiums 
for health insurance coverage called for by section 2794. The 
regulation established a rate review program to ensure that all rate 
increases that meet or exceed an established threshold are reviewed by 
a state or the Centers for Medicare and Medicaid Services (CMS) to 
determine whether the rate increases are unreasonable. Accordingly, 
issuers offering non-grandfathered health insurance coverage in the 
individual and/or small group markets are required to submit Rate 
Filing Justifications to CMS. Section 154.103 exempts grandfathered 
health plan coverage as defined in 45 CFR 147.140, excepted benefits as 
described in section 2791(c) of the PHS Act and student health 
insurance coverage, as defined in Sec.  147.145, from Federal rate 
review requirements.
    The Rate Filing Justification consists of three parts. All issuers 
must continue to submit a Uniform Rate Review Template (URRT) (Part I 
of the Rate Filing Justification) for all single risk pool plans. 
Section 154.200(a)(1) establishes a 15 percent federal default 
threshold for reasonableness review. Issuers that submit a rate filing 
that includes a plan that meets or exceeds the threshold must include a 
written description justifying the rate increase, also known as the 
consumer justification narrative (Part II of the Rate Filing 
Justification). We note that the threshold set by CMS constitutes a 
minimum standard and most states currently employ stricter rate review 
standards and may continue to do so. Issuers offering a QHP or any 
single risk pool submission containing a rate

[[Page 66711]]

increase of any size must continue to submit an actuarial memorandum 
(Part III of the Rate Filing Justification). Form Number: CMS-10379 
(OMB control number: 0938-1141); Frequency: Annually; Affected Public: 
Private Sector; Businesses or other for-profits, Not-for-profit 
institutions; Number of Respondents: 626; Total Annual Responses: 820; 
Total Annual Hours: 17,788. (For policy questions regarding this 
collection contact Lisa Cuozzo at 410-786-1746.)

    Dated: November 1, 2022.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2022-24098 Filed 11-3-22; 8:45 am]
BILLING CODE 4120-01-P