[Federal Register Volume 76, Number 105 (Wednesday, June 1, 2011)]
[Notices]
[Pages 31613-31614]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-13458]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10379]
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: Rate Increase Disclosure and Review Reporting
Requirements (45 CFR Part 154). Use: Under the Section 1003 of the
Affordable Care Act (Section 2794 of the Public Health Service Act),
The Secretary, in conjunction with the States, is required to establish
a process for the annual review, beginning with the 2010 plan year, of
unreasonable increases in premiums for health insurance coverage.
Section 2794 directs the Secretary to ensure the public disclosure of
information of unreasonable rate increases and justification for those
increases.
On December 23, 2010, CMS published a proposed rate review
regulation in the Federal Register for public comment (Rate Increase
Disclosure and Review Rule, 75 FR 81004). CMS revised the proposed rule
based on the public comments and published the final rate review
regulation in the Federal Register on May 19, 2011. The final rule
defines the unreasonable rate review process and issuer reporting and
disclosure requirements (Rate Increase Disclosure and Review Rule, 76
FR 29964). The
[[Page 31614]]
regulation establishes the following reporting requirements:
The Preliminary Justification: This data collection is
required of all health insurance issuers for all rate increases that
exceed the ``subject to review''' reporting threshold as defined in the
rule. This information will be posted on an HHS Web site.
Rate Review Final Determination: This data collection
requires States with effective rate review programs and CMS to report
their review findings and unreasonable rate increase determinations on
all rate increases that are subject to review. This information will be
posted on an HHS Web site.
The Final Justification for An Unreasonable Rate Increase:
This data collection is required of health insurance issuers that elect
to implement a rate increase that is determined to be unreasonable
based on State or CMS review. This information will be posted on the
Health Insurance Issuer's Web site and on a CMS Web site.
2. Preliminary Justification
The Preliminary Justification consists of three parts, Part I: Rate
Increase Summary, Part II: Written Explanation of the Rate Increase,
and Part III: Rate Filing Documentation. Issuers must complete Parts I
and II for all rate increases that exceed the reporting threshold as
defined in the rule. As described in the preamble of the rule, this
information would be collected to provide consumers with basic
information on all rate increases that are subject to review under the
rate review program.
Under the rule, ``subject to review'' rate increases would be
reviewed by either States or CMS, depending on whether a State has an
effective rate review program. Issuers would only be required to submit
Part III of the Preliminary Justification when CMS is conducting the
review of a rate increase that is ``subject to review.'' Accordingly,
Part III requires health insurance issuers to provide detailed rate
data that would be used for the purposes of conducting thorough
actuarial reviews and for making determinations about whether rate
increases are unreasonable. This Notice contains the following
information about the Preliminary Justification:
Preliminary Justification Issuer Instructions: Health
insurance issuer instructions for completing all three parts of the
Preliminary Justification.
Part I Worksheet: A standardized Excel worksheet that must
be used to complete Part I of the Preliminary Justification.
Sample Internet display of the Rate Review Consumer
Disclosure: Information provided in the Preliminary Justification would
be posted on an HHS Web site. This sample display shows how the
information contained in the Part I Worksheet would be displayed to
consumers.
3. Rate Review Final Determination
Under the rule, States and CMS would have to provide a Rate Review
Final Determination at the close of their review of all ``subject to
review'' rate increases. The Rate Review Final Determination must
provide the State's or CMS' determination on whether a rate increase is
`unreasonable'. Section 154.301(a)(3) of the rule provides a list of
actuarial review elements that must be taken into account as part of
the rate review process. The Final Determination must provide a brief
statement explaining how the review of elements set forth in Sec.
154.301(a)(3) caused the State or CMS to arrive at its determination
that the rate is unreasonable.
The Rate Review Final Determination will be entered into a data
entry text box in the Rate Review Data Collection System. CMS is
estimating that this statement would be approximately a paragraph in
length. There is no specific form or set of instructions associated
with this reporting requirement, apart from the reporting requirements
provided in the rule. The information provided in the Rate Review Final
Determination will be posted as part of the rate review consumer
disclosure information on an HHS Web site.
4. Final Justification for An Unreasonable Rate Increase
The rule states that if a health insurance issuer implements a rate
increase determined by CMS or a State to be unreasonable, the health
insurance issuer must provide a Final Justification for an Unreasonable
Rate Increase. In the Final Justification, issuers would have to
provide a short statement about why they are electing to implement an
unreasonable rate increase. This statement would be entered into a data
entry text box in the Rate Review Data Collection System and would not
need to be more than a paragraph or two in length. There is no form or
instructions associated with this statement apart from the requirements
provided in the regulation.
The Final Justification Statement will be posted on an HHS Web site
in the same location as the Preliminary Justification and Rate Review
Final Determination. Additionally, health insurance issuers
implementing rate increases that were determined to be unreasonable,
must post all of this information--the Preliminary Justification, the
Rate Review Final Determination, and the Final Justification Statement
on their Web sites for a period of 3 years. Form Number: CMS-10379;
(OCN: 0938-NEW) Frequency: Annually; Affected Public: Private Sector
and States; Number of Respondents: 452; Number of Responses: 3,571;
Total Annual Hours: 11,902. (For policy questions regarding this
collection, contact Sally McCarty at (301) 492-4489 or
[email protected]. For all other issues call 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 June 27, 2011.
OMB, Office of Information and Regulatory Affairs, Attention: CMS
Desk Officer, Fax Number: (202) 395-6974, E-mail: [email protected].
Dated: May 26, 2011.
Martique Jones,
Director, Regulations Development Group, Division B, Office of
Strategic Operations and Regulatory Affairs.
[FR Doc. 2011-13458 Filed 5-27-11; 8:45 am]
BILLING CODE 4120-01-P