[Federal Register Volume 78, Number 78 (Tuesday, April 23, 2013)]
[Notices]
[Pages 23936-23938]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-09541]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-9996-N4]
Early Retiree Reinsurance Program
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice sets forth termination dates for several processes
under the Early Retiree Reinsurance Program (ERRP) in preparation for
the January 1, 2014 program sunset date. These operational processes,
which involve plan sponsors and other parties, include: the submission
of changes to information in a plan sponsor's ERRP application; the
reporting of plan sponsor change of ownership; the submission of
reimbursement requests; the reporting and correction of data
inaccuracies; and the request for reopenings of reimbursement
determinations.
DATES: Effective Date: This notice is effective April 19, 2013.
FOR FURTHER INFORMATION CONTACT: David Mlawsky, (410) 786-6851.
SUPPLEMENTARY INFORMATION:
I. Background
The Patient Protection and Affordable Care Act (Pub. L. 111-148)
was enacted on March 23, 2010, and the Health Care and Education
Reconciliation Act of 2010 (Reconciliation Act) (Pub. L. 111-152) was
enacted on March 30, 2010. These laws are collectively referred to as
``Affordable Care Act.'' Section 1102 of the Affordable Care Act
directs the Secretary of Health and Human Services (HHS) to establish
the temporary Early Retiree Reinsurance Program (ERRP) to provide
reimbursement to eligible sponsors of employment-based plans for a
portion of the costs of providing health coverage to early retirees
(and eligible spouses, surviving spouses, and dependents of such
retirees), during the period beginning on the date on which the program
is established, and ending on January 1, 2014 (the ERRP sunset date).
Section 1102(a)(l) of the Affordable Care Act required the Secretary to
establish the program
[[Page 23937]]
within 90 days of enactment of the law (by June 21, 2010). Section
1102(e) of the Affordable Care Act appropriates funding of $5 billion
for the temporary program.
In the May 5, 2010 Federal Register (75 FR 24450), we published an
interim final regulation with comment period, implementing the program
as of June 1, 2010. Subsequently, we published several guidance
documents that further detailed program requirements and operations in
various sections of the rule (see the Regulations and Guidance section
and the Common Questions section on the ERRP public Web site at
www.errp.gov). Collectively, the regulations and guidance set forth
various requirements and processes associated with participation in the
ERRP. These requirements and processes include mandatory activities,
such as how to report and correct previously submitted data
inaccuracies, as well as elective activities, such as requesting a
reopening of a reimbursement determination.
Several of these requirements and processes require access to the
ERRP Secure Web site. The ERRP Secure Web site is used by plan sponsors
to complete several important operations, such as submitting
corrections to data inaccuracies and requesting reimbursement. As part
of ending the program, we are planning for the ERRP Secure Web site to
eventually be taken offline and archived and to conclude the remaining
operational processes.
This notice sets forth the termination dates for several
operational processes, including those that involve plan sponsors'
reporting and submitting of information, in preparation for
implementing the January 1, 2014 sunset date.
However, this notice does not limit the requirements in the ERRP
regulations at 45 CFR 149.350, which require plan sponsors (and
subcontractors, if applicable) to maintain and furnish to the HHS
Secretary upon request, certain records enumerated in those
regulations. Such records must be maintained for 6 years after the
expiration of the plan year in which the costs were incurred, or longer
if otherwise required by law. These timeframes set forth in 45 CFR
149.350 continue to apply, notwithstanding the ERRP sunset date or any
other dates set forth in this notice.
II. Provisions of This Notice
This notice describes how five operational processes will be
impacted by the January 1, 2014 sunset date: (1) Reporting changes to
information in ERRP applications; (2) reporting change of ownership;
(3) submitting reimbursement requests; (4) reporting and submitting
corrections to data inaccuracies; and (5) requesting the Secretary to
reopen and revise an adverse reimbursement determination. Presented
below are the specifics of how these operational processes will be
impacted.
A. Date After Which Plan Sponsors No Longer Must Report Changes to
Information in Their ERRP Applications
The ERRP regulations at 45 CFR 149.35 require a plan sponsor that
wishes to participate in the ERRP to submit an application to the
Secretary, in the manner and at the time required by the Secretary, as
specified in 45 CFR 149.40. The application must contain all the
information specified in 45 CFR 149.40 to be approved. Currently, a
plan sponsor with an approved application is required to report updates
to information contained in its application.\1\ CMS expects plan
sponsors to update by December 31, 2013, all information that they know
is inaccurate. Contact and banking information should be updated in the
ERRP Secure Web site.
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\1\ See Common Question 100-8, under the Application tab in the
Common Questions section of www.errp.gov.
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All other application information should be updated by amendment of
the paper ERRP application. After December 31, 2013, plan sponsors will
no longer be required to update information contained in either their
paper application or the ERRP Secure Web site. Any plan sponsor that is
the subject of an active audit as of December 31, 2013, still will be
required to keep both CMS and the ERRP Program Integrity Contractor
informed of the most current contact information for their Authorized
Representative, Account Manager, and any other critical points of
contact, until such time that the audit is completed. The plan sponsor
must communicate changes to contact information by phone call or email
to the ERRP Contact Center and ERRP Program Integrity Contractor.
B. Date After Which Plan Sponsors No Longer Must Report Change of
Ownership
The ERRP regulations at 45 CFR 149.700 define change of ownership,
and require plan sponsors that are considering or negotiating a change
of ownership to notify the Secretary at least 60 days before the
anticipated effective date of the change. In preparation for the ERRP
sunset date, a plan sponsor need not notify the Secretary of any such
change of ownership in instances where the anticipated effective date
of the change would occur after December 31, 2013.
C. Last Date Plan Sponsors May Submit Reimbursement Requests
The ERRP regulations at 45 CFR 149.300 state: ``Reimbursement under
this program is conditioned upon the provision of accurate information
by the plan sponsor or its designee. The information must be submitted,
in a form and manner and at the times provided in this subpart and
other guidance specified by the Secretary.'' In various guidance
documents published on www.errp.gov, CMS specified the form, manner,
and times for submitting reimbursement requests. As part of ending the
program, we are planning for the ERRP Secure Web site to eventually be
taken offline and archived, and to conclude the remaining operational
processes. In preparation for the ERRP sunset date, the last day upon
which a plan sponsor may submit an ERRP reimbursement request is July
31, 2013.\2\ This termination date will allow for a phase down of ERRP
operational processes related to the ERRP Secure Web site.
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\2\ To meet this deadline, a plan sponsor must take into account
the timeframe it may take to submit a new Early Retiree List (if its
most recent one has expired), an error-free Claim List, and a
Reimbursement Request. A plan sponsor must also take into account
the timeframes for CMS to make available to the plan sponsor an
Early Retiree List Response File (up to 7 business days), and a
Claim List Response File (2-4 calendar days). See all relevant
training and guidance materials at www.errp.gov.
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D. Date After Which Plan Sponsors Are No Longer Required To Submit
Corrections to Data Inaccuracies
The ERRP regulations at 45 CFR 149.600 state: ``A sponsor is
required to disclose any data inaccuracies upon which a reimbursement
determination is made, including inaccurate claims data and negotiated
price concessions, in a manner and at a time specified by the Secretary
in guidance.'' CMS specified the form, manner, and times for submitting
corrections to data inaccuracies in various guidance documents
published on www.errp.gov. The primary guidance document setting forth
how plan sponsors must correct data inaccuracies states that plan
sponsors must submit a reimbursement request that includes corrected
data, no later than the end of the next calendar quarter after the plan
sponsor knows, or should know, of the data inaccuracy.\3\
[[Page 23938]]
Because the process for submitting corrections to data inaccuracies
leverages the process for submitting reimbursement requests, we have
concluded that plan sponsors will no longer be required to submit
corrections to data inaccuracies after July 31, 2013, that is, the last
day upon which a plan sponsor may submit an ERRP reimbursement request.
This means that plan sponsors that know or should know, before or on
April 30, 2013, of any data inaccuracy contained in a reimbursement
request for a plan year for which a reimbursement determination was
made, must submit corrections to the data inaccuracy in a manner
consistent with the ERRP regulations and guidance.\4\ A plan sponsor
that does not know with certainty its final amount of price concessions
for a given plan year, but knows or should know, as of April 30, 2013,
of estimates that vary from previously reported price concession
amounts for that plan year, must consider those previous amounts to
constitute data inaccuracies, and therefore is required to report and
correct that data by July 31, 2013.
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\3\ See Explanation of the Processes for Reporting Early Retiree
and Claims Data Inaccuracies, and for Reopening, under the
Regulations and Guidance section at www.errp.gov.
\4\ See footnotes 2 and 3. However, as discussed above, a
sponsor that knows or should know, before or on April 30, 2013, of
any data inaccuracy contained in a reimbursement request for a plan
year for which a reimbursement determination was made, must submit a
reimbursement request with corrected data by July 31, 2013, rather
than by no later than the end of the next calendar quarter after the
sponsor knows or should know of the data inaccuracy.
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E. Last Day Plan Sponsors May Submit a Request To Reopen and Revise an
Adverse Reimbursement Determination
The ERRP regulations at 45 CFR 149.610 permit the Secretary to
reopen and revise a reimbursement determination upon the Secretary's
own motion or upon the request of a plan sponsor. The regulations, as
well as guidance published on www.errp.gov,\5\ set forth the process by
which a plan sponsor may request a reopening, as well as other
information related to reopenings. In preparation for the ERRP sunset
date, the last day upon which a plan sponsor may submit an ERRP
reopening request is December 31, 2013.
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\5\ See footnote 3.
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III. Collection of Information Requirements
Under the Paperwork Reduction Act of 1995, we are required to
provide 60-day notice in the Federal Register and solicit public
comment before a collection of information requirement is submitted to
the Office of Management and Budget (OMB) for review and approval. The
information collection requirements associated with the ERRP are
currently approved under OMB control number 0938-1087, with an
expiration date of September 30, 2014. This document does not impose
any new information collection and recordkeeping requirements beyond
the prior estimates in the supporting statement for the interim final
rule, CMS-9995-IFC. Consequently, it need not be reviewed by the Office
of Management and Budget under the authority of the Paperwork Reduction
Act of 1995.
Authority: Sections 1102(a)(l) of the Affordable Care Act (42
U.S.C. Sec. 18002(a)(l) and(c)(4)).
Dated: April 16, 2013.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2013-09541 Filed 4-19-13; 11:15 am]
BILLING CODE 4120-01-P