[Federal Register Volume 78, Number 12 (Thursday, January 17, 2013)]
[Notices]
[Pages 3898-3899]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-00858]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10142 and CMS-R-262]
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: Revision of a currently
approved collection; Title of Information Collection: Bid Pricing Tool
(BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans
(PDP); Use: Under the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA), and implementing regulations at 42
CFR, Medicare Advantage organizations (MAO) and Prescription Drug Plans
(PDP) are required to submit an actuarial pricing ``bid'' for each plan
offered to Medicare beneficiaries for approval by the Centers for
Medicare & Medicaid Services (CMS).
Title I of the MMA established a program to offer prescription drug
benefits to Medicare enrollees through Prescription Drug Plans. MMA
Title II revised several aspects of the Medicare+Choice program
(renamed Medicare Advantage), including the payment methodology and the
introduction of ``Regional'' MA plans. CMS payments to PDPs and MA
plans will be on a market-based competitive approach.
MAOs and PDPs use the Bid Pricing Tool (BPT) software to develop
their actuarial pricing bid. The information provided in the BPT is the
basis for the plan's enrollee premiums and CMS payments for each
contract year. The tool collects data such as medical expense
development (from claims data and/or manual rating), administrative
expenses, profit levels, and projected plan enrollment information. By
statute, completed BPTs are due to CMS by the first Monday of June each
year.
CMS reviews and analyzes the information provided on the Bid
Pricing Tool. Ultimately, CMS decides whether to approve the plan
pricing (i.e., payment and premium) proposed by each organization. CMS
is requesting to
[[Page 3899]]
continue its use of the BPT for the collection of information for
CY2014 through CY2016. Form Number: CMS-10142 (OCN: 0938-0944);
Frequency: Yearly; Affected Public: Private Sector--Business or other
for-profits and not-for-profit institutions; Number of Respondents:
555; Total Annual Responses: 4,995; Total Annual Hours: 149,850. (For
policy questions regarding this collection contact Diane Spitalnic at
410-786-5745. For all other issues call 410-786-1326.)
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Plan Benefit
Package (PBP) and Formulary Submission for Medicare Advantage (MA)
Plans and Prescription Drug Plans (PDP); Use: Under the Medicare
Modernization Act (MMA), Medicare Advantage (MA) and Prescription Drug
Plan (PDP) organizations are required to submit plan benefit packages
for all Medicare beneficiaries residing in their service area. The plan
benefit package submission consists of the Plan Benefit Package (PBP)
software, formulary file, and supporting documentation, as necessary.
MA and PDP organizations use the PBP software to describe their
organization's plan benefit packages, including information on
premiums, cost sharing, authorization rules, and supplemental benefits.
They also generate a formulary to describe their list of drugs,
including information on prior authorization, step therapy, tiering,
and quantity limits. Additionally, CMS uses the PBP and formulary data
to review and approve the plan benefit packages proposed by each MA and
PDP organization.
After receiving OMB clearance in spring 2000, CMS implemented the
PBP as part of the Contract Year (CY) 2001 Adjusted Community Rate
Proposal (ACRP) process. In addition, information collected via the PBP
and formulary has been used to support the marketing material review
process, the National Medicare Education Program, and other program
oversight and development activities. For instance, the PBP software
automatically generates the standardized sentences for the Summary of
Benefits (SB) by using the plan benefit package data entered into the
PBP software by the organization's user. These standardized sentences
are used by the MA organizations in their SB marketing materials and by
CMS to generate plan benefits data for display in the Medicare & You
handbook and on the www.medicare.gov Web site.
CMS is requesting to continue its use of the PBP software and
formulary submission for the collection of benefits and related
information for CY 2014 through CY 2016. CMS estimates that 578 MA
organizations and 63 PDP organizations will be required to submit the
plan benefit package information in CY 2014. Based on operational
changes and policy clarifications to the Medicare program and continued
input and feedback by the industry, CMS has made the necessary changes
to the plan benefit package submission. Form Number: CMS-R-262 (OCN:
0938-0763); Frequency: Yearly; Affected Public: Private Sector--
Business or other for-profits and not-for-profit institutions; Number
of Respondents: 641; Total Annual Responses: 6,169; Total Annual Hours:
56,708. (For policy questions regarding this collection contact Kristy
Holtje at 410-786-2209. 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.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html, 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.
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. on February 19,
2013. OMB, Office of Information and Regulatory Affairs, Attention: CMS
Desk Officer, Fax Number: (202) 395-6974, Email: [email protected].
Dated: January 11, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2013-00858 Filed 1-16-13; 8:45 am]
BILLING CODE 4120-01-P