[Federal Register Volume 88, Number 108 (Tuesday, June 6, 2023)]
[Notices]
[Pages 37065-37066]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-12013]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10716 and CMS-1450]


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 July 6, 2023.

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.

[[Page 37066]]


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: Revision of a currently 
approved collection; Title of Information Collection: Applicable 
Integrated Plan Coverage Decision Letter; Use: Sections 1859(f)(8) of 
the Act require development of unified grievance and appeals processes 
for D-SNPs, to the extent feasible. We finalized the implementation of 
this regulation for integrated organization determinations at Sec.  
422.631, effective January 1, 2021. This rule requires applicable 
integrated plans to send an enrollee a written notice of any adverse 
decision on an integrated organization determination using a notice 
that is written in plain language and contains the information detailed 
at Sec.  422.631(d)(1)(iii).
    Applicable integrated plans as defined at Sec.  422.561 are 
required to issue form CMS-10716 when a request for either a medical 
service or payment is denied in whole or in part after considering both 
the Medicare or Medicaid benefit. Applicable integrated plans issue 
this form to enrollees when the plan reduces, stops, suspends, or 
denies, in whole or in part, a request for a service or item (including 
a Part B drug) or a request for payment of a service or item (including 
a Part B drug) that the enrollee has already received. The form 
provides the enrollee with information regarding their right to an 
appeal of the applicable integrated plan's decision and the enrollee 
will use the instructions to navigate the appeal process. Form Number: 
CMS-10716 (OMB control number: 0938-1386); Frequency: Occasionally; 
Affected Public: Private sector (Business or other for-profits); Number 
of Respondents: 112; Total Annual Responses: 24,716; Total Annual 
Hours: 4,120. (For policy questions regarding this collection contact 
Kristi Sugarman Coats at 415-744-3629.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Uniform 
Institutional Providers Form; Use: The UB-04 CMS-1450 is managed by the 
National Uniform Billing Committee (NUBC), sponsored by the American 
Hospital Association. Most payers are represented on this body, and the 
UB-04 is widely used in the industry. Medicare Part A MACs use the 
information on the UB-04 CMS-1450 to determine whether to make Medicare 
payment for the services provided, the payment amount, and whether or 
not to apply deductibles to the claim. The same method is also used by 
other payers. CMS is also a secondary user of data. CMS uses the 
information to develop a database, which is used to update, and revise 
established payment schedules and other payment rates for covered 
services. CMS also uses the information to conduct studies and reports. 
Form Number: CMS-1450 (OMB control number: 0938-0997); Frequency: 
Annually; Affected Public: State, Local, or Tribal Governments; Number 
of Respondents: 53,111; Total Annual Responses: 193,535,941; Total 
Annual Hours: 1,617,010. (For policy questions regarding this 
collection contact Charlene Parks at 410-786-8684.)

    Dated: June 1, 2023.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2023-12013 Filed 6-5-23; 8:45 am]
BILLING CODE 4120-01-P