[Federal Register Volume 88, Number 10 (Tuesday, January 17, 2023)]
[Notices]
[Pages 2625-2626]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-00732]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers CMS-10108, CMS-10243, CMS-10275 and CMS-10062]


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 March 20, 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-10108 Medicaid Managed Care and Supporting Regulations
CMS-10243 Testing Experience and Functional Tools (TEFT): Functional 
Assessment Standardized Items (FASI) Based on the CARE Tool
CMS-10275 The Home Health Care CAHPS[supreg] Survey (HHCAHPS)
CMS-10062 Collection of Diagnostic Data in the Abbreviated RAPS Format

    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: Medicaid Managed 
Care and Supporting Regulations; Use: Information collected includes 
information about managed care programs, grievances and appeals, 
enrollment broker contracts, and managed care organizational capacity 
to provide health care services. Medicaid enrollees use the information 
collected and reported to make informed choices regarding health care, 
including how to access health care services and the grievance and 
appeal system. States use the information collected and reported as 
part of its contracting process with managed care entities, as well as 
its compliance oversight role. We use the information collected and 
reported in an oversight role of state Medicaid managed care programs.
    Among the proposed changes, this iteration: (1) adds burden for a 
new submission process, via online portal, for states to submit 
contracts to CMS and to note an omission from prior packages for the 
burden for states to submit their managed care plan contracts via 
email, and (2) adds burden to provide a reporting template for those 
states that implemented COVID-19 specific risk mitigation strategies to 
their managed care plan contracts. This template will ensure that 
states provide consistent and complete reporting of the outcomes of 
these risk mitigation strategies. Form Number: CMS-10108 (OMB control 
number: 0938-0920); Frequency: Occasionally; Affected Public: Private 
sector (business or other for-profit and not-for-profit institutions), 
and State, local or Tribal Government; Number of Respondents: 5,053; 
Total Annual Responses: 13,743,255; Total Annual Hours: 1,682,636. (For 
policy questions regarding this collection contact Amy Gentile at 410-
786-3499.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Testing 
Experience and Functional Tools (TEFT): Functional Assessment 
Standardized Items (FASI) Based on the CARE Tool; Use: As part of the 
National Testing Experience and Functional Assessment Tools (TEFT) 
demonstration, CMS tested the use of functional assessment standardized 
items (FASI) among community-based long term services and supports (CB-
LTSS) populations. The TEFT initiative built on the national efforts to 
create electronically exchangeable data across providers and the 
caregiving team to develop more person-centered services under the 
Medicare and Medicaid programs. After conclusion of the field test, 
states have begun implementing the related FASI performance measures 
and the FASI team continues to recruit additional states. While the 
team has not conducted data collection since the FASI field test in 
2017, and that there are no concrete immediate plans to collect new 
data, new data collection to support measure re-endorsement activities 
due in 2025 will be needed. The data collection may also need to be

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conducted sooner if significant changes are made to the measures' 
technical specifications, in the interim. Due to the uncertainty on 
when data collection may need to be done, an extension of the existing 
package and a subsequent revision would facilitate expedient resumption 
of the data collection and testing efforts, especially given the quick 
turnaround time for activities (such as National Quality Forum measure 
endorsement) which depend on the data collection.
    FASI is based on a subset of the July 27, 2007 (72 FR 144) 
Continuity Assessment Record and Evaluation (CARE) items which are now 
included in post-acute setting Federal assessment forms for nursing 
facilities--Resident Assessment Instrument (RAI) Minimum Data Set 
(MDS), Inpatient Rehabilitation Facilities Patient Assessment 
Instrument (IRF-PAI), and Long Term Care Hospitals Continuity 
Assessment Record & Evaluation (CARE) Data Set (LCDS) to measure 
function in a standardized way. The FASI items include the standardized 
mobility and self-care items included in the MDS, IRF-PAI, and, LCDS as 
well as some additional mobility items appropriate to measuring 
independence in the community and personal preferences or goals items 
related to function. Also included are certain instrumental activities 
of daily living and some modified caregiver assistance items from the 
Home Health Outcome and Assessment Information Set (OASIS) tool. A few 
additional items to describe the populations' age, gender, and 
geographic area of residence are also included. Use of the same items 
to measure functional status in nursing facilities and community-based 
programs will help states report on their rebalancing efforts. Also, 
because these items will have electronic specifications developed by 
CMS, they can assist state efforts to develop exchangeable electronic 
data to follow the person across services and estimate total costs as 
well as measure functional status across time. The complete FASI set is 
included in this information collection request. Form Number: CMS-10243 
(OMB control number: 0938-1037); Frequency: On occasion; Affected 
Public: Individuals and Households; Number of Respondents: 1,570; Total 
Annual Responses: 1,570; Total Annual Hours: 785. (For policy questions 
regarding this collection contact Kerry Lida at 410-786-4826.)
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: The Home Health 
Care CAHPS[supreg] Survey (HHCAHPS); Use: The national implementation 
of the Home Health Care CAHPS Survey is designed to collect ongoing 
data from samples of home health care patients who receive skilled 
services from Medicare-certified home health agencies. The survey is 
necessary because it fulfills the goal of transparency with the public 
about home health patient experiences.
    The survey is used by Medicare-certified home health agencies to 
improve their internal quality assurance in the care that they provide 
in home health. The HHCAHPS survey is also used in a Medicare payment 
program. Medicare-certified home health agencies (HHAs) must contract 
with CMS-approved survey vendors that conduct the HHCAHPS on behalf of 
the HHAs to meet their requirements in the Home Health Quality 
Reporting Program. Form Number: CMS-10275 (OMB control number: 0938-
1066); Frequency: Quarterly; Affected Public: Individuals and 
Households; Number of Respondents: 1,052,966; Total Annual Responses: 
1,149,975; Total Annual Hours: 420,576. (For policy questions regarding 
this collection contact Lori Luria at 410-786-6684).
    4. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Collection of 
Diagnostic Data in the Abbreviated RAPS Format from Medicare Advantage 
Organizations for Risk Adjusted Payments; Use: Under section 1894(d) of 
the Act, CMS must make prospective monthly capitated payments to PACE 
organizations in the same manner and from the same sources as payments 
to organizations under section 1853. Section 1894(e)(3)(A)(i) requires 
in part that PACE organizations collect data and make available to the 
Secretary reports necessary to monitor the cost, operation, and 
effectiveness of the PACE program.
    CMS makes advance monthly per-enrollee payments to organizations, 
and is required to risk-adjust the payments based on predicted relative 
health care costs for each enrollee, as determined by enrollee-specific 
diagnoses and other factors, such as age. CMS has collected diagnosis 
data from organizations in two formats: (1) comprehensive data 
equivalent to Medicare fee-for-service claims data (often referred to 
as encounter data) and (2) data in an abbreviated format known as RAPS 
data, named for the Risk Adjustment Processing System (RAPS). The 
subject of this PRA package is collection of RAPS data. Encounter data 
collection is addressed in a separate PRA package which is approved 
under OMB control number 0938-1152.
    Risk adjustment allows CMS to pay plans for the health risk of the 
beneficiaries they enroll, instead of paying an identical an average 
amount for each enrollee Medicare beneficiaries. By risk adjusting plan 
payments, CMS is able to make appropriate and accurate payments for 
enrollees with differences in expected costs. Risk adjustment is used 
to adjust bidding and payment based on the health status and 
demographic characteristics of an enrollee. Risk scores measure 
individual beneficiaries' relative risk and the risk scores are used to 
adjust payments for each beneficiary's expected expenditures. By risk 
adjusting plan bids, CMS is able to also use standardized bids as base 
payments to plans. Form Number: CMS-10062 (OMB control number: 0938-
0878); Frequency: Quarterly; Affected Public: Private Sector, Business 
or other for-profit and Not-for-profit institutions; Number of 
Respondents: 284; Total Annual Responses: 80,235,720; Total Annual 
Hours: 2,674,524. (For policy questions regarding this collection 
contact Amanda Johnson at 410-786-4161.

    Dated: January 11, 2023.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2023-00732 Filed 1-13-23; 8:45 am]
BILLING CODE 4120-01-P