[Federal Register Volume 77, Number 174 (Friday, September 7, 2012)]
[Notices]
[Page 55216]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-22087]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10003]
Agency Information Collection Activities: Proposed Collection;
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) 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 functions; (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: Revision of a currently
approved collection.
Title of Information Collection: Notice of Denial of Medical
Coverage (or Payment); Use: In the July 6, 2012, Federal Register (77
FR 40064), the Centers for Medicare and Medicaid Services (CMS)
published a 60-day notice regarding the information collection request
approved under 0938-0829. However, due to technical difficulties, the
documents associated with the information collection request were not
made available to the public until August 14, 2012. Because of the
technical difficulties, CMS is republishing the notice to allow the
public to have a full 60-day comment period.
Section 1852(g)(1)(B) of the Social Security Act (SSA) requires
Medicare health plans to provide enrollees with a written notice in
understandable language that explains the plan's reasons for denying a
request for a service or payment for a service the enrollee has already
received. The written notice must also include a description of the
applicable appeals processes. Regulatory authority for this notice is
set forth in Subpart M of Part 422 at 42 CFR 422.568, 422.572,
417.600(b), and 417.840.
Section 1932 of the Social Security Act (SSA) sets forth
requirements for Medicaid managed care plans, including beneficiary
protections related to appealing a denial of coverage or payment. The
Medicaid managed care appeals regulations are set forth in Subpart F of
Part 438 of Title 42 of the CFR. Rules on the content of the written
denial notice can be found at 42 CFR 438.404.
This notice combines the existing Notice of Denial of Medicare
Coverage with the Notice of Denial of Payment and includes optional
language to be used in cases where a Medicare health plan enrollee also
receives full Medicaid benefits that are being managed by the Medicare
health plan. Form Number: CMS-10003 (OCN: 0938-0829). Frequency:
Occasionally. Affected Public: Private Sector (business or other for-
profits, not-for-profit institutions). Number of Respondents: 665.
Total Annual Responses: 6,960,410. Total Annual Hours: 1,159,604. (For
policy questions regarding this collection contact Gladys Wheeler at
410-786-0273. For all other issues call 410-786-1326.)
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 Email your request, including your address, phone number, OMB
number, and CMS document identifier, to [email protected], or call
the Reports Clearance Office on (410) 786-1326.
In commenting on the proposed information collections please
reference the document identifier or OMB control number. To be assured
consideration, comments and recommendations must be submitted in one of
the following ways by November 6, 2012:
1. Electronically. You may submit 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) 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.
Dated: September 4, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-22087 Filed 9-6-12; 8:45 am]
BILLING CODE 4120-01-P