[Federal Register Volume 73, Number 193 (Friday, October 3, 2008)]
[Notices]
[Pages 57631-57632]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-23415]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10261, CMS-10182, CMS-10166 and CMS-10150]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid
Services (CMS), Department of Health and Human Services, is publishing
the following summary of proposed collections for public comment.
Interested persons are invited to send comments regarding this burden
estimate or any other aspect of this collection of information,
including any of the following subjects: (1) The necessity and utility
of the proposed information collection for the proper performance of
the Agency's function; (2) the accuracy of the estimated burden; (3)
ways to enhance the quality, utility, and clarity of the information to
be collected; and (4) the use of automated collection techniques or
other forms of information technology to minimize the information
collection burden.
1.Type of Information Collection Request: New collection; Title of
Information Collection: Part C Medicare Advantage (MA) Reporting
Requirements and Supporting Regulations in 42 CFR 422.516 (a); Use: CMS
has authority to establish reporting requirements for Medicare
Advantage Organizations (MAOs) as described in 42 CFR 422.516(a). Under
that authority, each MAO must have an effective procedure to develop,
compile, evaluate, and report to CMS, to its enrollees, and to the
general public, at the times and in the manner that CMS requires, and
while safeguarding the confidentiality of the doctor-patient
relationship, statistics and other information with respect to the cost
of its operations, patterns of service utilization, availability,
accessibility, and acceptability of its services, developments in the
health status of its enrollees, and other matters that CMS may require.
CMS will not require cost plans to comply with the following
reporting requirements: Benefit utilization; procedure frequency; and
serious reportable adverse events. However, CMS has determined that it
is essential that all beneficiaries understand rules and requirements
of the Medicare plans which they are being invited to join. Prospective
enrollees in cost plans should be furnished accurate information by
qualified sales people, consistent with CMS' expectation for
prospective enrollees in other play types. Thus, CMS is requiring
reporting on certain measures CMS' believes is critical in monitoring
cost plans. Additionally, CMS believes that section 1876(i)(1)(D) of
the Act, and 42 CFR 417.126(a)(6) permits CMS to require cost plans to
report to CMS the data identified as follows: Provider network
adequacy; grievances; organization determinations/reconsiderations;
employer group plan sponsor; agent training and testing; agent
commission structure and plan oversight of agents.
Data collected via Medicare Part C Reporting Requirements will be
an integral resource for oversight,
[[Page 57632]]
monitoring, compliance and auditing activities necessary to ensure
quality provision of the benefits provided by MA plans to enrollees.
Refer to the ``Summary of Revisions'' document for a list of the recent
collection changes. Form Number: CMS-10261 (OMB 0938-New);
Frequency: Yearly, Quarterly, and Semi-annually; Affected Public:
Business or other for-profits; Number of Respondents: 718; Total Annual
Responses: 12,709; Total Annual Hours: 286,944.
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Model Creditable
Coverage Disclosure Notices; Use: Section 1860D-1 of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and
implementing regulations at 42 CFR 423.56 require that entities that
offer prescription drug benefits under any of the types of coverage
described in 42 CFR 423.56 (b) provide a disclosure of creditable
coverage status to all Medicare Part D eligible individuals covered
under the entity's plan informing them whether such coverage meets the
actuarial requirements specified in guidelines provided by CMS.
These disclosure notices must be provided to Part D eligible
individuals, at minimum, at the following times: (1) Prior to an
individual's initial enrollment period for Part D, as described under
Sec. 423.38 (a); (2) prior to the effective date of enrollment in the
entity's coverage, and upon any change in creditable status; (3) prior
to the commencement of the Part D Annual Coordinated Election Period
(ACEP) which begins on November 15 of each year, as defined in Sec.
423.38 (b); and (4) upon request by the individual. In an effort to
reduce the burden associated with providing these notices, our final
regulations allow most entities to provide notices of creditable and
non-creditable status with other information materials that these
entities distribute to beneficiaries.
This collection has been updated by eliminating the separate Model
Personalized Disclosure Notice. CMS has incorporated the personalized
information into the Model Creditable Disclosure Notice and the Model
Non-Creditable Disclosure Notice for use by the public Form Number:
CMS-10182 (OMB 0938-0990); Frequency: Yearly and Semi-
annually; Affected Public: Federal Government, Business or Other For-
Profits and Not-for-Profit Institutions, and State, Local or Tribal
Governments; Number of Respondents: 1,225,173; Total Annual Responses:
1,225,173; Total Annual Hours: 522,204.
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Payment Error
Rate Measurement in Medicaid and the State Children Health Insurance
Program (SCHIP); Use: The Improper Payments Information Act (IPIA) of
2002 requires CMS to produce national error rates for Medicaid and
State Children's Health Insurance Program (SCHIP). To comply with the
IPIA, CMS will engage a Federal contractor to produce the error rates
in Medicaid and SCHIP.
The States will be requested to submit, at their option, test data
which include full claims details to the contractor prior to the
quarterly submissions to detect potential problems in the dataset and
ensure the quality of the data. These States will be required to submit
quarterly claims data to the contractor who will pull a statistically
valid random sample, each quarter, by strata, so that medical and data
processing reviews can be performed. State-specific error rates will be
based on these review results.
CMS needs to collect the claims data, medical policies, and other
information from States as well as medical records from providers in
order for the contractor to sample and review adjudicated claims in
those States selected for review. Based on the reviews, state-specific
error rates will be calculated which will serve as the basis for
calculating national Medicaid and SCHIP error rates.
This revision of the currently approved collection contains minor
revisions to the information collection requirements. There is a 10-
hour increase in burden per State per program as part of a new process.
Based on the past experience in PERM operation, the adjustment is made
to ensure the quality of the data will comply with the data requirement
during the measurement. Form Number: CMS-10166 (OMB 0938-
0974); Frequency: Quarterly, Yearly; Affected Public: State, Local or
Tribal Governments; Number of Respondents: 34; Total Annual Responses:
4,080; Total Annual Hours: 28,560.
4.Type of Information Collection Request: Extension without change
of a currently approved collection; Title of Information Collection:
Collection of Drug Pricing and Network Pharmacy Data from Medicare
Prescription Drug Plans (PDPs and MA-PDs) and Supporting Regulations in
42 CFR 423.48; Use: Both stand alone prescription drug plans (PDPs) and
Medicare Advantage Prescription Drug (MA-PDs) plans are required to
submit drug pricing and pharmacy network data to CMS and these data are
made publicly available to people with Medicare through the Medicare
Prescription Drug Plan Finder Web tool on http://www.medicare.gov. Drug
prices vary across a plans pharmacy network based on the contracts that
each plan negotiates with each pharmacy or pharmacy chain in their
networks. The pharmacy networks can change during the course of the
year as new pharmacies open, close, change ownership, or plans
negotiate new contracts with pharmacies resulting in different
dispensing fees for prescriptions. Drug prices also change frequently
due to the daily fluctuation of the Average Wholesale Price (AWP), thus
plans increase or decrease their drug prices to reflect these changes.
The purpose of the data is to enable prospective and current Medicare
beneficiaries to compare, learn, select and enroll in a plan that best
meets their needs. The database structure provides the necessary drug
pricing and pharmacy network information to accurately communicate plan
information in a comparative format. Form Number: CMS-10150
(OMB 0938-0951); Frequency: Bi-weekly; Affected Public:
Business or other for-profits; Number of Respondents: 680; Total Annual
Responses: 17,680; Total Annual Hours: 70,720.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS Web
site address at http://www.cms.hhs.gov/PaperworkReductionActof1995, or
e-mail your request, including your address, phone number, OMB number,
and CMS document identifier, to Paperwork@cms.hhs.gov, or call the
Reports Clearance Office on (410) 786-1326.
To be assured consideration, comments and recommendations for the
proposed information collections must be received by the OMB desk
officer at the address below, no later than 5 p.m. onNovember 3, 2008.
OMB, Office of Information and Regulatory Affairs, Attention: CMS
Desk Officer, New Executive Office Building, Room 10235, Washington, DC
20503, Fax Number: (202) 395-6974.
Dated: September 26, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. E8-23415 Filed 10-2-08; 8:45 am]
BILLING CODE 4120-01-P