[Federal Register Volume 79, Number 124 (Friday, June 27, 2014)]
[Notices]
[Pages 36516-36518]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-15075]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-10526, CMS-2540-10, CMS-265-11, CMS-10106
and CMS-R-235]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid 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 (the 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 60 days for public
comment on the proposed action. Interested persons are invited to send
comments regarding our burden estimates or any other aspect of this
collection of information, including any of the following subjects: (1)
The necessity and utility of the proposed
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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.
DATES: Comments must be received by August 26, 2014.
ADDRESSES: When commenting, please reference the document identifier or
OMB control number (OCN). To be assured consideration, comments and
recommendations must be submitted in any one of the following ways:
1. Electronically. You may send 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) that are 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.
To obtain copies of a supporting statement and any related forms
for the proposed collection(s) summarized in this notice, you may make
your request using one of following:
1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
2. Email your request, including your address, phone number, OMB
number, and CMS document identifier, to [email protected].
3. Call the Reports Clearance Office at (410) 786-1326.
FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.
SUPPLEMENTARY INFORMATION:
Contents
This notice sets out a summary of the use and burden associated
with the following information collections. More detailed information
can be found in each collection's supporting statement and associated
materials (see ADDRESSES).
CMS-10526 Cost Sharing Reduction Reconciliation
CMS-2540-10 Skilled Nursing Facility and Skilled Nursing Facility
Health Care Complex Cost Report
CMS-265-11 Independent Renal Dialysis Facility Cost Report and
Supporting Regulations
CMS-10106 Medicare Authorization to Disclose Personal Health
Information
CMS-R-235 Data Use Agreement (DUA) for Data Acquired from the Centers
for Medicare & Medicaid Services (CMS)
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 requires federal agencies to publish a 60-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.
Information Collection
1. Type of Information Collection Request: New collection (Request
for a new OMB control number); Title of Information Collection: Cost
Sharing Reduction Reconciliation; Use: Under established Department of
Health and Human Services (HHS) regulations, qualified health plan
(QHP) issuers will receive estimated advance payments of cost-sharing
reductions throughout the year. Each issuer will then be subject to a
reconciliation process at the end of the benefit year to ensure that
HHS reimburses each issuer only for actual cost sharing. This
information collection establishes the data elements that a QHP issuer
would be required to report to HHS in order to establish the cost-
sharing reductions provided on behalf of enrollees for the benefit
year.
Form Number: CMS-10526 (OMB control number: 0938-NEW); Frequency:
Annually; Affected Public: Private Sector--Business or other for-
profits; Number of Respondents: 295; Total Annual Responses: 4,000,000;
Total Annual Hours: 2,469. (For policy questions regarding this
collection contact Patricia Meisol at 410-786-1917.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Skilled Nursing
Facility and Skilled Nursing Facility Health Care Complex Cost Report;
Use: Providers of services participating in the Medicare program are
required under sections 1815(a), 1833(e) and 1861(v)(1)(A) of the
Social Security Act (42 U.S.C. 1395g) to submit annual information to
achieve settlement of costs for health care services rendered to
Medicare beneficiaries. In addition, regulations at 42 CFR 413.20 and
413.24 require adequate cost data and cost reports from providers on an
annual basis. Form CMS-2540-10 is used by Skilled Nursing Facilities
(SNFs) and Skilled Nursing Facility Complexes participating in the
Medicare program to report health care costs to determine the amount of
reimbursable costs for services rendered to Medicare beneficiaries.
Form Number: CMS-2540-10 (OMB control number: 0938-0463);
Frequency: Yearly; Affected Public: Private Sector--Business or other
for-profits and Not-for-profit institutions; Number of Respondents:
14,185; Total Annual Responses: 14,185; Total Annual Hours: 2,865,370.
(For policy questions regarding this collection contact Amelia Citerone
at 410-786-3901.)
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Independent Renal
Dialysis Facility Cost Report and Supporting Regulations; Use:
Providers of services participating in the Medicare program are
required under sections 1815(a) and 1861(v)(1)(A) of the Social
Security Act (42 U.S.C. 1395g) to submit annual information to achieve
settlement of costs for health care services rendered to Medicare
beneficiaries. In addition, regulations at 42 CFR 413.20 and 413.24
require adequate cost data and cost reports from providers on an annual
basis. The Form CMS-265-11 cost report is needed to determine a
provider's reasonable costs incurred in furnishing medical services to
Medicare beneficiaries.
Form Number: CMS-265-11 (OMB control number: 0938-0263); Frequency:
Yearly; Affected Public: Private Sector--Business or other for-profits
and Not-for-profit institutions; Number of Respondents: 5,677; Total
Annual Responses: 5,677; Total Annual Hours: 369,005. (For policy
questions regarding this collection contact Gail Duncan at 410-786-
7278.)
4. Type of Information Collection Request: Reinstatement without
change of a previously approved collection; Title of Information
Collection: Medicare Authorization to Disclose Personal Health
Information; Use: Unless permitted or required by law, the
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Health Insurance Portability and Accountability Act (HIPAA) prohibits
Medicare (a HIPAA covered entity) from disclosing an individual's
protected health information without a valid authorization. In order to
be valid, an authorization must include specified core elements and
statements. Medicare will make available to Medicare beneficiaries a
standard, valid authorization to enable beneficiaries to request the
disclosure of their protected health information. This standard
authorization will simplify the process of requesting information
disclosure for beneficiaries and minimize the response time for
Medicare. Form CMS-10106, the Medicare Authorization to Disclose
Personal Health Information, will be used by Medicare beneficiaries to
authorize Medicare to disclose their protected health information to a
third party. Form Number: CMS-10106 (OMB control number: 0938-0930);
Frequency: Occasionally; Affected Public: Individuals or Households;
Number of Respondents: 1,298,329; Total Annual Responses: 1,298,329;
Total Annual Hours: 324,582. (For policy questions regarding this
collection contact Sam Jenkins at 410-786-3261.)
5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Data Use
Agreement (DUA) for Data Acquired from the Centers for Medicare &
Medicaid Services (CMS); Use: The Privacy Act of 1974 allows for
discretionary releases of data maintained in Privacy Act protected
systems of records under Sec. 552a(b) (Conditions of Disclosure). The
mandate to account for disclosures of data under the Privacy Act is
found at Sec. 552a(c)(Accounting of Certain Disclosures). This section
states that certain information must be maintained regarding
disclosures made by each agency. This information is: Date, Nature,
Purpose, and Name/Address of Recipient. Section 552a(e) sets the
overall requirements that each agency must meet in order to maintain
records under the Privacy Act. The Data Use Agreement (DUA) form is
needed as part of the review of each CMS data request to ensure
compliance with the requirements of the Privacy Act for disclosures
that contain personally identifiable information (PII). The DUA form
also provides data requestors and custodians with a formal means to
agree to the data protection and destruction statutory and regulatory
requirements of CMS' PII data. The Health Insurance Portability and
Accountability Act (HIPAA) of 1996, Sec. 1173(d) (Security Standards
for Health Information) requires us to protect PII. Additionally, the
Federal Information Security Management Act (FISMA) of 2002, Sec. 3544
(b) (Federal Agency Responsibilities--Agency Program) also requires us
to develop policies and procedures for the protection and destruction
of sensitive data to include PII. We use the information collected by
the DUA to track disclosures, conditions for disclosure, accounting of
disclosures and agency requirements dictated by the Privacy Act, HIPAA
and FISMA.
Form Number: CMS-R-235 (OMB control number: 0938-0734); Frequency:
Annually; Affected Public: Private sector--business or other for-
profits and not-for-profit institutions; Number of Respondents: 9,220;
Total Annual Responses: 9,220; Total Annual Hours: 2,740. (For policy
questions regarding this collection contact Sharon Kavanagh at 410-786-
5441.)
Dated: June 24, 2014.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2014-15075 Filed 6-26-14; 8:45 am]
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