[Federal Register Volume 90, Number 239 (Tuesday, December 16, 2025)]
[Notices]
[Page 58248]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-22974]
[[Page 58248]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10718 and CMS-10824]
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 January 15, 2026.
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: Revision with change of
a currently approved collection; Title of Information Collection: Model
Medicare Advantage and Medicare Prescription Drug Plan Individual
Enrollment Request Form; Use: The enrollment form is considered a
``model'' under Medicare regulations at Sec. Sec. 422.2267 and
423.2267, for purposes of communication and marketing review and
approval; therefore, MA and Part D plans are able to modify the
language, format, or order of the enrollment form. The model enrollment
form includes the minimal amount of information to process the
enrollment, located in Section 1 of the MA/PDP enrollment form, and
other limited information, in Section 2, that the sponsor is required
(i.e. accessible format preference) or chooses (i.e. premium payment
information) to provide to the beneficiary. The optional data elements,
which aids the MA and Part D plan in processing the enrollment, is
developed for efficiency for the plan. Plan sponsors can obtain
information at the initial point of contact to help streamline the
beneficiary's enrollment process. The optional questions include
information specific to the plan's business needs that serves to reduce
overall burden and allow for timely processing of an enrollment
request. All data elements in Section 2 are optional for the
beneficiary to complete. Plan enrollment will not be affected if the
beneficiary does not complete this additional information. Form Number:
CMS-10718 (OMB control number 0938-1378); Frequency: Occasionally;
Affected Public: Individuals and Households, Private sector and
Business or other for-profits; Number of Respondents: 24,464,437;
Number of Responses: 49,917,959; Total Annual Hours: 12,240,174. (For
questions regarding this collection, contact: AnhViet Nguyen at (667)
290-9745 or [email protected]).
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Annual Notice of
Change and Evidence of Coverage for Applicable Integrated Plans in
States that Require Integrated Materials; 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.
This information collection maintains standardized EOC and ANOC
models for Dual Eligible Special Needs Plan (D-SNP) applicable
integrated plans (AIPs), as defined at Sec. 422.561, in certain States
that chose to require that plans issue an integrated EOC and ANOC that
covers the Medicare and Medicaid benefits. The models reflect revisions
to the D-SNP models under CMS-10260 to include information on Medicaid
benefits that State Medicaid agencies can customize. Form Number: CMS-
10824 (OMB control number: 0938-1444); Frequency: Yearly; Affected
Public: Private Sector, Business or other for profits; Number of
Respondents: 109; Total Annual Responses: 109; Total Annual Hours:
1,308. (For policy questions regarding this collection contact Julie
Jones at 312-353-9850 or [email protected].)
William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts,
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2025-22974 Filed 12-15-25; 8:45 am]
BILLING CODE 4120-01-P