[Federal Register Volume 87, Number 240 (Thursday, December 15, 2022)]
[Notices]
[Pages 76626-76628]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-27166]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS-10527, CMS-10260, CMS-10836 and CMS-855A]


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 (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 February 13, 2023.

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, 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 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-10527 Annual Eligibility Redetermination, Product Discontinuation 
and Renewal Notice
CMS-10260 Medicare Advantage and Prescription Drug Program: Final 
Marketing Provisions in 42 CFR 422.111(a)(3) and 423.128(a)(3)
CMS-10836 Medicare Plan Performance Warning Information
CMS-855A Medicare Enrollment Application for Institutional Providers

    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: Revision of a currently 
approved collection; Title of Information Collection: Annual 
Eligibility Redetermination, Product Discontinuation and Renewal 
Notice; Use: Section 1411(f)(1)(B) of the Affordable Care Act directs 
the Secretary of Health and Human Services (the Secretary) to establish 
procedures to redetermine the eligibility of individuals for premium 
tax credits on a periodic basis in appropriate circumstances. Section 
1321(a) of the Affordable Care Act provides authority for the Secretary 
to establish standards and regulations to implement the statutory 
requirements related to Exchanges, qualified health plans (QHPs) and 
other components of title I of the Affordable Care Act. Under section 
2703 of the Public Health Service Act (PHS Act), as added by the 
Affordable Care Act, and former section 2712 and section 2741 of the 
PHS Act, enacted by the Health Insurance Portability and Accountability 
Act of 1996, health insurance issuers in the group and individual 
markets must guarantee the renewability of coverage unless an exception 
applies.
    The 2014 final rule ``Patient Protection and Affordable Care Act; 
Annual Eligibility Redeterminations for Exchange Participation and 
Insurance Affordability Programs; Health Insurance Issuer Standards 
Under the Affordable Care Act, Including Standards Related to 
Exchanges'' (79 FR 52994, September 5, 2014), provides that an Exchange 
may choose to conduct the annual redetermination process for a plan 
year (1) in accordance with the existing procedures described in 45 CFR 
155.335; (2) in accordance with procedures described in guidance issued 
by the Secretary for the applicable benefit year; or (3) using an 
alternative procedure proposed by the Exchange and approved by the 
Secretary. The 2014 final rule established a renewal and reenrollment 
hierarchy at 45 CFR 155.335(j) to minimize potential enrollment 
disruptions. The 2016 final rule ``Patient Protection and Affordable 
Care Act; HHS Notice of Benefit and Payment Parameters for 2017'' (81 
FR 12204, March 8, 2016) amended the enrollment

[[Page 76627]]

hierarchy to further minimize potential disruptions of enrollee 
eligibility for cost-sharing reductions.
    The guidance document ``Guidance on Annual Eligibility 
Redetermination and Re-enrollment for Exchange Coverage for 2019 and 
Later Years'' contains the procedures that the Secretary is specifying 
for the coverage year, as noted in (2) above, and specifies that these 
procedures will be used by all Exchanges using the federal eligibility 
and enrollment platform, unless otherwise specified in future guidance 
or rulemaking.
    The 2014 final rule also amended the requirements for product 
renewal and re-enrollment (or non-renewal) notices to be sent by QHP 
issuers in the Exchanges and specifies content for these notices. The 
guidance document ``Updated Federal Standard Renewal and Product 
Discontinuation Notices, and Enforcement Safe Harbor for Product 
Discontinuation Notices in Connection with the Open Enrollment Period 
for Coverage in the Individual Market in the 2020 Benefit Year'' 
provides standard notices for product discontinuation and renewal to be 
sent by issuers of individual market QHPs and issuers in the individual 
market.\1\
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    \1\ Updated Federal Standard Renewal and Product Discontinuation 
Notices, and Enforcement Safe Harbor for Product Discontinuation 
Notices in Connection with the Open Enrollment Period for Coverage 
in the Individual Market in the 2020 Benefit Year (July 30, 2019) 
available at: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Updated-Federal-Standard-Notices-and-Enforcement-Safe-Harbor-for-Discontinuation-Notices-PY2020.pdf. This bulletin 
was revised on July 31, 2020 to add a link to the federal standard 
notices to be used beginning in the 2021 plan year: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Updated-Federal-Standard-Notices-for-coverage-beginning-in-the-2021-plan-year.pdf.
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    The federal standard notices to be sent by issuers of individual 
market QHPs and issuers in the individual market have been revised to 
improve consumer understanding and update out-of-date information. The 
revised notices in this information collection will be required for 
notices provided in connection with coverage beginning in the 2024 plan 
year.
    Issuers in the small group market may use the draft federal 
standard small group notices released in the June 26, 2014 bulletin 
``Draft Standard Notices When Discontinuing or Renewing a Product in 
the Small Group or Individual Market'', or any forms of the notice 
otherwise permitted by applicable laws and regulations. States that are 
enforcing the guaranteed renewability provisions of the Affordable Care 
Act may develop their own standard notices for product discontinuances, 
renewals, or both, provided the state-developed notices are at least as 
protective as the federal standard notices. Form Number: CMS-10527 (OMB 
control number: 0938-1254); Frequency: Annually; Affected Public: 
Private Sector, State, Local, or Tribal Governments; Number of 
Respondents: 1,340; Total Annual Responses: 5,881; Total Annual Hours: 
72,147. (For policy questions regarding this collection contact Usree 
Bandyopadhyay at 410-786-6650.)
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Medicare 
Advantage and Prescription Drug Program: Final Marketing Provisions in 
42 CFR 422.111(a)(3) and 423.128(a)(3); Use: CMS requires MA 
organizations and Part D sponsors to use the standardized documents 
being submitted for OMB approval to satisfy disclosure requirements 
mandated by section 1851 (d)(3)(A) of the Act and Sec.  422.111 for MA 
organizations and section 1860D-1(c) of the Act and Sec.  423.128(a)(3) 
for Part D sponsors. The regulatory provisions at Sec. Sec.  422.111(b) 
and 423.128(b) require MA organizations and Part D sponsors to disclose 
plan information, including: service area, benefits, access, grievance 
and appeals procedures, and quality improvement/assurance requirements. 
MA organizations and sponsors may send the ANOC separately from the 
EOC, but must send the ANOC for enrollee receipt by September 30. The 
required due date for the EOC is 15 days prior to the start of the AEP.
    CMS requires MA organization and Part D sponsors to submit 
marketing materials to CMS for review prior to the MA organization or 
sponsor distributing those materials to the public. In section 1851(h), 
paragraphs (1), (2), and (3) establish this requirement for MA 
organizations. Section 1860D-1(b)(1)(B)(vi) directs Part D sponsors to 
follow the same requirements in section 1851(h) that MA organizations 
must follow for this purpose. Form number: CMS-10260 (OMB control 
number: 0938-1051); Frequency: Annually; Affected Public: State, Local, 
or Tribal Governments; Number of Respondents: 800; Number of Responses: 
48,439; Total Burden Hours: 13,568. (For questions regarding this 
collection contact Elizabeth Jacob at 410-786-8658).
    3. Type of Information Collection Request: New collection (Request 
for new OMB control number); Title of Information Collection: Medicare 
Plan Performance Warning Information; Use: The Centers for Medicare & 
Medicaid Services (CMS) is seeking approval to collect information to 
assist in the Agency's response to two reports from the Department of 
Health and Human Services Office of the Inspector General (OIG) related 
to how the agency conveys information on plan performance.
    CMS is conducting this research to respond to OIG's recommendations 
related to sharing additional information with beneficiaries on plan 
performance in a clear and accessible format, particularly related to 
information which may warn or caution beneficiaries about plan 
performance issues. CMS is seeking to learn more about how 
beneficiaries, caregivers, and the intermediaries who assist them use 
and understand the information CMS currently makes (or may make) 
available, as well as to assess their interest in accessing this 
information. Form number: CMS-10836 (OMB control number: 0938-New); 
Frequency: Annually; Affected Public: Individuals and Households; 
Number of Respondents: 288; Number of Responses: 288; Total Burden 
Hours: 497. (For questions regarding this collection contact Elizabeth 
Goldstein at 443 845-6993).
    4. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Medicare 
Enrollment Application for Institutional Providers; Use: The primary 
function of the CMS-855A Medicare enrollment application is to gather 
information from a certified provider or certified supplier that tells 
us who it is, whether it meets certain qualifications to be a health 
care provider, where it practices or renders services, the identity of 
its owners, and other information necessary to establish correct claims 
payments.
    In addition, on July 26, 2022, CMS published in the Federal 
Register a proposed rule titled ``Medicare Program: Hospital Outpatient 
Prospective Payment and Ambulatory Surgical Center Payment Systems and 
Quality Reporting Programs; Organ Acquisition; Rural Emergency 
Hospitals: Payment Policies, Conditions of Participation, Provider 
Enrollment, Physician Self-Referral; New Service Category for Hospital 
Outpatient Department Prior Authorization Process; Overall Hospital 
Quality Star Rating'' (CMS-1772-P) (87 FR 44502). This proposed rule 
outlined requirements that rural emergency hospitals (REHs)--a new 
Medicare provider type established pursuant to Section 125 of Division 
CC of the Consolidated Appropriations Act, 2021--must meet in order to 
bill Medicare for REH services. This

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information collection request addresses the burden associated with the 
completion of the applicable CMS-855A by REHs in order to enroll in 
Medicare.
    As part of this request, and as described in the supporting 
statement, we also seek approval for additional changes to the CMS-
855A. These changes principally (though not exclusively) involve the 
collection of information related to the provider's ownership. Form 
Number: CMS-855A (OMB control number: 0938-0685); Frequency: On 
occasion; Affected Public: Business or other for-profits, not-for-
profit institutions; Number of Respondents: 1,340; Total Annual 
Responses: 5,881; Total Annual Hours: 72,147. (For policy questions 
regarding this collection contact Frank Whelan at 410-786-1302.)

    Dated: December 9, 2022.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2022-27166 Filed 12-14-22; 8:45 am]
BILLING CODE 4120-01-P