[Federal Register Volume 78, Number 8 (Friday, January 11, 2013)]
[Pages 2408-2409]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-00468]



Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10408 and CMS-10338]

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: Reinstatement with 
change of a previously approved collection; Title of Information 
Collection: Early Retiree Reinsurance Program Survey of Plan Sponsors; 
Use: Under the Patient Protection and Affordable Care Act (42 U.S.C. 
18002) and implementing regulations at 45 CFR Part 149, employment-
based plans that offer health coverage to early retirees and their 
spouses, surviving spouses, and dependents are eligible to receive tax-
free reimbursement for a portion of the costs of health benefits 
provided to such individuals. The statute limits how the reimbursement 
funds can be used, and requires the Secretary of HHS to develop a 
mechanism to monitor the appropriate use of such funds. The survey that 
is the subject of this information collection request, is part of that 
mechanism. CMS published a 60-day FR Notice on September 28, 2012 (77 
FR 59615). The comment ended on November 27, 2012. No comments were 
received in response to this notice. Form Number: CMS-10408 (OCN: 0938-
1150); Frequency: Yearly; Affected Public: Private Sector: Business or 
other for-profit and not-for-profit institutions; Public Sector; Number 
of Respondents: 927; Total Annual Responses: 927; Total Annual Hours: 
10,197. (For policy questions regarding this collection contact David 
Mlawsky at (410) 786-6851. For all other issues call (410) 786-1326.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title: Affordable Care Act Internal Claims and 
Appeals and External Review Procedures for Non-grandfathered Group 
Health Plans and Issuers and Individual Market Issuers; Use: The 
Patient Protection and Affordable Care Act, Public Law 111-148, (the 
Affordable Care Act) was enacted by President Obama on March 23, 2010. 
As part of the Act, Congress added PHS Act section 2719, which provides 
rules relating to internal claims and appeals and external review 
processes. On July 23, 2010, interim final regulations (IFR) set forth 
rules implementing PHS Act section 2719 for internal claims and appeals 
and external review processes. With respect to internal claims and 
appeals processes for group health coverage, PHS Act section 2719 and 
paragraph (b)(2)(i) of the interim final regulations provide that group 
health plans and health insurance issuers offering group health 
insurance coverage must comply with the internal claims and appeals 
processes set forth in 29 CFR 2560.503-1 (the DOL claims procedure 
regulation) and update such processes in accordance with standards 
established by the Secretary of Labor in paragraph (b)(2)(ii) of the 
regulations. The DOL claims procedure regulation requires an employee 
benefit plan to provide third-party notices and disclosures to 
participants and beneficiaries of the plan. In addition, paragraphs 
(b)(3)(ii)(C) and (b)(2)(ii)(C) of the IFR add an additional 
requirement that non-grandfathered group health plans and issuers of 
non-grandfathered health policies provide to the claimant, free of 
charge, any new or additional evidence considered, or generated by the 
plan or issuer in connection with the claim. Paragraph (b)(3)(i) of the 
IFR requires issuers offering coverage in the individual health 
insurance market to also generally comply with the DOL claims procedure 
regulation as updated by the Secretary of HHS in paragraph (b)(3)(ii) 
of the IFR for their internal claims and appeals processes.
    Furthermore, PHS Act section 2719 and the IFR provide that non-
grandfathered group health plans, issuers offering group health 
insurance coverage, and self-insured nonfederal governmental plans 
(through the IFR amendment dated June 24, 2011) must comply either with 
a state external review process or a federal external review process. 
The IFR provides a basis for determining when such plans and issuers 
must comply with an applicable state external review process and when 
they must comply with the federal external review process. Plans and 
issuers that are required to participate in the Federal external review 
process must have electronically elected either the HHS-administered 
process or the private accredited IRO process as of January 1, 2012, 
or, in the future, at such time as the plans and issuers use the 
federal external review process. Plans and issuers must notify HHS as 
soon as possible if any of the above information changes at any time 
after it is first submitted. The election requirements associated with 
this ICR are articulated through guidance published June 22, 2011 at 
The election requirements are necessary for the federal external review 
process to provide an independent external review as requested by 
claimants. Form Number: CMS-10338 (OCN: 0938-1099); Frequency: 
Occasionally; Affected Public: State, Local, Tribal Governments; 
business or other for-profit; not-for-profit institutions; Number of 
Respondents: 46,773; Number of Responses: 218,657,161;

[[Page 2409]]

Total Annual Hours: 930,267. (For policy questions regarding this 
collection, contact Linda Greenberg at (301) 492-4225. 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 Paperwork@cms.hhs.gov, 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 11, 
2013: OMB, Office of Information and Regulatory Affairs, Attention: CMS 
Desk Officer, Fax Number: (202) 395-6974, Email: OIRA_submission@omb.eop.gov.

    Dated: January 8, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2013-00468 Filed 1-10-13; 8:45 am]