Agency Information Collection Activities: Submission for OMB Review; Comment Request, 11222-11224 [2017-03369]
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11222
Federal Register / Vol. 82, No. 33 / Tuesday, February 21, 2017 / Notices
utility of the proposed information
collection for the proper performance of
the agency’s functions, the accuracy of
the estimated burden, ways to enhance
the quality, utility, and clarity of the
information to be collected and the use
of automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
DATES: Comments on the collection(s) of
information must be received by the
OMB desk officer by March 23, 2017.
ADDRESSES: When commenting on the
proposed information collections,
please reference the document identifier
or OMB control number. To be assured
consideration, comments and
recommendations must be received by
the OMB desk officer via one of the
following transmissions: OMB, Office of
Information and Regulatory Affairs,
Attention: CMS Desk Officer, Fax
Number: (202) 395–5806 or, Email:
OIRA_submission@omb.eop.gov.
To obtain copies of a supporting
Board of Governors of the Federal Reserve
statement and any related forms for the
System, February 14, 2017.
proposed collection(s) summarized in
Yao-Chin Chao,
this notice, you may make your request
Assistant Secretary of the Board.
using one of following:
[FR Doc. 2017–03258 Filed 2–17–17; 8:45 am]
1. Access CMS’ Web site address at
BILLING CODE 6210–01–P
https://www.cms.hhs.gov/
PaperworkReductionActof1995.
2. Email your request, including your
DEPARTMENT OF HEALTH AND
address, phone number, OMB number,
HUMAN SERVICES
and CMS document identifier, to
Paperwork@cms.hhs.gov.
Centers for Medicare & Medicaid
3. Call the Reports Clearance Office at
Services
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
[Document Identifiers: CMS–10487, CMS–
R–71, CMS–10171, CMS–10260, CMS–10275, Reports Clearance Office at (410) 786–
CMS–10396, and CMS–R–266]
1326.
SUPPLEMENTARY INFORMATION: Under the
Agency Information Collection
Paperwork Reduction Act of 1995 (PRA)
Activities: Submission for OMB
(44 U.S.C. 3501–3520), federal agencies
Review; Comment Request
must obtain approval from the Office of
Management and Budget (OMB) for each
AGENCY: Centers for Medicare &
collection of information they conduct
Medicaid Services, HHS.
or sponsor. The term ‘‘collection of
ACTION: Notice.
information’’ is defined in 44 U.S.C.
3502(3) and 5 CFR 1320.3(c) and
SUMMARY: The Centers for Medicare &
Medicaid Services (CMS) is announcing includes agency requests or
requirements that members of the public
an opportunity for the public to
submit reports, keep records, or provide
comment on CMS’ intention to collect
information to a third party. Section
information from the public. Under the
3506(c)(2)(A) of the PRA (44 U.S.C.
Paperwork Reduction Act of 1995
3506(c)(2)(A)) requires federal agencies
(PRA), federal agencies are required to
to publish a 30-day notice in the
publish notice in the Federal Register
Federal Register concerning each
concerning each proposed collection of
proposed collection of information,
information, including each proposed
extension or reinstatement of an existing including each proposed extension or
reinstatement of an existing collection
collection of information, and to allow
of information, before submitting the
a second opportunity for public
collection to OMB for approval. To
comment on the notice. Interested
comply with this requirement, CMS is
persons are invited to send comments
publishing this notice that summarizes
regarding the burden estimate or any
the following proposed collection(s) of
other aspect of this collection of
information, including the necessity and information for public comment:
sradovich on DSK3GMQ082PROD with NOTICES
Unless otherwise noted, comments
regarding the applications must be
received at the Reserve Bank indicated
or the offices of the Board of Governors
not later than March 7, 2017.
A. Federal Reserve Bank of
Philadelphia (William Spaniel, Senior
Vice President) 100 North 6th Street,
Philadelphia, Pennsylvania 19105–
1521. Comments can also be sent
electronically to
Comments.applications@phil.frb.org:
1. The Toronto-Dominion Bank,
Toronto, Ontario, Canada, and its
wholly owned subsidiaries, TD Group
US Holdings, LLC, Wilmington,
Delaware; TD Bank US Holding
Company, Cherry Hill, New Jersey; and
TD Bank N.A., Wilmington, Delaware;
to acquire Scottrade Financial Services,
Inc., St. Louis, Missouri, a savings and
loan holding company, and to merge
Scottrade Bank, St. Louis, Missouri, a
federal savings association, into TD
Bank N.A.
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1. Type of Information Collection
Request: Extension of a previously
approved collection; Title of
Information Collection: Medicaid
Emergency Psychiatric Demonstration
(MEPD) Evaluation; Use: Since the
inception of Medicaid, inpatient care
provided to adults ages 21 to 64 in
institutions for mental disease (IMDs)
has been excluded from federal
matching funds. The Emergency
Medical Treatment and Active Labor
Act (EMTALA), however, requires IMDs
that participate in Medicare to provide
treatment for psychiatric emergency
medical conditions (EMCs), even for
Medicaid patients for whose services
cannot be reimbursed. Section 2707 of
the Affordable Care Act (ACA) directs
the Secretary of Health and Human
Services to conduct and evaluate a
demonstration project to determine the
impact of providing payment under
Medicaid for inpatient services
provided by private IMDs to individuals
with emergency psychiatric conditions
between the ages of 21 and 64. We will
use the data to evaluate the Medicaid
Emergency Psychiatric Demonstration
(MEPD) in accordance with the ACA
mandates. This evaluation in turn will
be used by Congress to determine
whether to continue or expand the
demonstration. If the decision is made
to expand the demonstration, the data
collected will help to inform both CMS
and its stakeholders about possible
effects of contextual factors and
important procedural issues to consider
in the expansion, as well as the
likelihood of various outcomes. Form
Number: CMS–10487 (OMB control
number: 0938–NEW); Frequency:
Annually; Affected Public: Individuals
and households; State, Local and Tribal
governments; Business and other forprofits and Not-for-profits; Number of
Respondents: 93; Total Annual
Responses: 1,944; Total Annual Hours:
2,046. (For policy questions regarding
this collection contact Vetisha McClair
at 410–786–4923.)
2. Type of Information Collection
Request: Extension of a previously
approved collection; Title of
Information Collection: Quality
Improvement Organization (QIO)
Assumption of Responsibilities and
Supporting Regulations; Use: The Peer
Review Improvement Act of 1982
amended Title XI of the Social Security
Act to create the Utilization and Quality
Control Peer Review Organization (PRO)
program which replaces the Professional
Standards Review Organization (PSRO)
program and streamlines peer review
activities. The term PRO has been
renamed Quality Improvement
E:\FR\FM\21FEN1.SGM
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sradovich on DSK3GMQ082PROD with NOTICES
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Organization (QIO). This information
collection describes the review
functions to be performed by the QIO.
It outlines relationships among QIOs,
providers, practitioners, beneficiaries,
intermediaries, and carriers. Form
Number: CMS–R–71 (OMB Control
Number: 0938–0445); Frequency:
Yearly; Affected Public: Business or
other for-profit and Not-for-profit
institutions; Number of Respondents:
6,939; Total Annual Responses:
489,750; Total Annual Hours: 1,479,346.
(For policy questions regarding this
collection contact Tennille Coombs at
410–786–3472.)
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Collecting
Benefit Coordination Data; Use: This
collection of information request
coordinates Part D plan prescription
drug coverage with other prescription
drug coverage. The collected
information will assist CMS, Part D
plans and other payers with
coordination of prescription drug
benefits at the point-of-sale and tracking
of the beneficiary’s True out-of-pocket
(TrOOP) expenditures using the Part D
Transaction Facilitator (PDTF). Form
Number: CMS–10171 (OMB control
number: 0938–0978); Frequency: Yearly
and occasionally; Affected Public:
Business or other for-profits; Number of
Respondents: 62,438; Total Annual
Responses: 891,777,634; Total Annual
Hours: 5,201,718. (For policy questions
regarding this collection contact Shelly
Winston at 410–786–3694.)
4. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare
Advantage and Prescription Drug
Program: Final Marketing Provisions in
42 CFR 422.111(a)(3) and 423.128(a)(3);
Use: We require that Medicare
Advantage (MA) organizations and Part
D sponsors use standardized documents
to satisfy disclosure requirements
mandated by section 1851(d)(3)(A) of
the Social Security Act (Act) and 42
CFR 422.111(b) for MA organizations,
and section 1860D–1(c) of the Act and
42 CFR 423.128(a)(3) for Part D
sponsors. The regulatory provisions
require that MA organizations and Part
D sponsors disclose plan information,
including: Service area, benefits, access,
grievance and appeals procedures, and
quality improvement and quality
assurance requirements by September
30th of each year. The MA organizations
and Part D sponsors use the information
to comply with the disclosure
requirements. We will use the approved
standardized documents to ensure that
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17:15 Feb 17, 2017
Jkt 241001
correct information is disclosed to
current and potential enrollees.
For 2017, CMS has a total of nine
standardized ANOC/EOC documents:
Health Maintenance Organization, Cost,
Dual Eligible Special Needs, Medicare
Medical Savings Account, Private-FeeFor-Service, Preferred Provider
Organizations, Preferred Provider
Organization with Prescription Drugs,
Health Maintenance Organization with
Prescription Drug, and Prescription
Drug. These standardized documents
will be used by MA organizations and
Part D sponsors for the 2018 contract
year.
In revising the standardized ANOC/
EOCs for contract year 2018, we did not
add to or remove any section from the
prior contract year ANOC/EOC models.
MA organizations and Part D sponsors
are still required to use the standardized
language in the ANOC/EOC models and
to send this document to current
members at least 15 days prior to the
start of the annual enrollment period or
by September 30, 2017 for the 2018
enrollment season, based on 42 CFR
422.111(a) (3) and 423.128(a)(3). Form
Number: CMS–10260 (OMB control
number: 0938–1051); Frequency: Yearly;
Affected Public: Private sector (Business
or other for-profits); Number of
Respondents: 805; Total Annual
Responses: 805; Total Annual Hours:
9,660. (For policy questions regarding
this collection contact Gladys Valentin
at 410–786–1620.)
5. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: CAHPS Home
Health Care Survey; Use: The national
implementation of the Home Health
Care Consumer Assessment of
Healthcare Providers and Systems
(CAHPS®) Survey is designed to collect
ongoing data from samples of home
health care patients who receive skilled
services from Medicare-certified home
health agencies. The data collected from
the national implementation of the
Home Health Care CAHPS Survey will
be used for the following purposes: (1)
To produce comparable data on the
patients’ perspectives of the care they
receive from home health agencies, (2)
to create incentives for agencies to
improve the quality of care they provide
through public reporting of survey
results, and (3) to enhance public
accountability in health care by
increasing the transparency of the
quality of care provided in return for the
public investment. Sampling and data
collection will be conducted on a
monthly basis. Survey results will be
analyzed and reported on a quarterly
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11223
basis, with publicly reported results
based on one year’s worth of data.
As part of this information collection
request for the national implementation
of Home Health Care CAHPS, CMS is
also requesting approval to conduct a
randomized mode experiment with a
sample of home health agencies. The
mode experiment compared the
responses to the survey across the three
proposed modes to determine whether
adjustments are needed to ensure that
the data collection mode does not
influence the survey results. In addition,
data from the mode experiment will be
used to determine which, if any, patient
characteristics may affect the patients’
rating of the care they receive and, if so,
develop an adjustment model of those
data based on those factors. CMS
worked with RTI, the federal contractor
to recruit approximately 100 home
health agencies to participate in the
mode experiment. The mode
experiment included approximately
23,000 home health care patients. Form
Number: CMS–10275 (OMB control
number: 0938–1066); Frequency:
Quarterly; Affected Public: Individuals
and households, Business or other forprofit and Not-for-profit institutions;
Number of Respondents: 2,715,890;
Total Annual Responses: 2,715,890;
Total Annual Hours: 699,440. (For
policy questions regarding this
collection contact Lori Teichman at
410–786–6684.)
6. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Medication
Therapy Management Program
Improvements; Use: Information
collected by Part D medication therapy
management programs (as required by
the standardized format for the
comprehensive medication review
summary) will be used by beneficiaries
or their authorized representatives,
caregivers, and their healthcare
providers to improve medication use
and achieve better healthcare outcomes.
Form Number: CMS–10396 (OMB
control number 0938–1154); Frequency:
Occasionally; Affected Public: Business
or other for-profits; Number of
Respondents: 599; Total Annual
Responses: 1,211,661; Total Annual
Hours: 807,451. (For policy questions
regarding this collection contact
Victoria Dang at 410–786–3991.)
7. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Medicaid
Disproportionate Share Hospital (DSH)
Annual Reporting Requirements; Use:
States are required to submit an annual
report that identifies each
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disproportionate share hospital (DSH)
that received a DSH payment under the
state’s Medicaid program in the
preceding fiscal year and the amount of
DSH payments paid to that hospital in
the same year along with other
information that the Secretary
determines necessary to ensure the
appropriateness of DSH payments; Form
Number: CMS–R–266 (OMB control
number: 0938–0746); Frequency: Yearly;
Affected Public: State, Local, or Tribal
Governments; Number of Respondents:
51; Total Annual Responses: 51; Total
Annual Hours: 2,142. (For policy
questions regarding this collection
contact Robert Lane at 410–786–2015.)
Dated: February 15, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2017–03369 Filed 2–17–17; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10398]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, Department of
Health and Human Services.
ACTION: Notice.
AGENCY:
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
the necessity and utility of the proposed
information collection for the proper
performance of the agency’s functions,
the accuracy of the estimated burden,
ways to enhance the quality, utility, and
clarity of the information to be
collected, and the use of automated
collection techniques or other forms of
information technology to minimize the
information collection burden.
sradovich on DSK3GMQ082PROD with NOTICES
SUMMARY:
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17:15 Feb 17, 2017
Jkt 241001
Comments must be received by
April 24, 2017.
ADDRESSES: When commenting, please
reference the document identifier or
OMB control number. 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 https://
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 lll, 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
https://www.cms.hhs.gov/
PaperworkReductionActof1995.
2. Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
Reports Clearance Office at (410) 786–
1326.
DATES:
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–10398 Reconciliation of State
Invoice and Prior Quarter Adjustment
Statement
Under the 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
PO 00000
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Sfmt 9990
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: Revision of a currently
approved collection; Title of
Information Collection: Generic
Clearance for Medicaid and CHIP State
Plan, Waiver, and Program Submissions;
Use: State Medicaid and CHIP agencies
are responsible for developing
submissions to CMS, including state
plan amendments and requests for
waivers and program demonstrations.
States use templates when they are
available and submit the forms to
review for consistency with statutory
and regulatory requirements (or in the
case of waivers and demonstrations
whether the proposal is likely to
promote the objectives of the Medicaid
program). If the requirements are met,
we approve the states’ submissions
giving them the authority to implement
the flexibilities. For a state to receive
Medicaid Title XIX funding, there must
be an approved Title XIX state plan.
The development of streamlined
submissions forms enhances the
collaboration and partnership between
states and CMS by documenting our
policy for states to use as they are
developing program changes.
Streamlined forms improve efficiency of
administration by creating a common
and user-friendly understanding of the
information we need to quickly process
requests for state plan amendments,
waivers, and demonstration, as well as
ongoing reporting.
Form Number: CMS–10398 (OMB
control number: 0938–1148); Frequency:
Collection-specific, but generally the
frequency is yearly, once, and
occasionally; Affected Public: State,
Local, or Tribal Governments; Number
of Respondents: 56; Total Responses:
1,540 (3-year total); Total Hours:
214,584 (3-year total). (For policy
questions regarding this collection
contact Annette Pearson at 410–786–
6858.)
Dated: February 15, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2017–03370 Filed 2–17–17; 8:45 am]
BILLING CODE 4120–01–P
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Agencies
[Federal Register Volume 82, Number 33 (Tuesday, February 21, 2017)]
[Notices]
[Pages 11222-11224]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-03369]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-10487, CMS-R-71, CMS-10171, CMS-10260, CMS-
10275, CMS-10396, and CMS-R-266]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
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 (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 a second opportunity
for public comment on the notice. Interested persons are invited to
send comments regarding the burden estimate or any other aspect of this
collection of information, including the necessity and utility of the
proposed information collection for the proper performance of the
agency's functions, the accuracy of the estimated burden, ways to
enhance the quality, utility, and clarity of the information to be
collected and the use of automated collection techniques or other forms
of information technology to minimize the information collection
burden.
DATES: Comments on the collection(s) of information must be received by
the OMB desk officer by March 23, 2017.
ADDRESSES: When commenting on the proposed information collections,
please reference the document identifier or OMB control number. To be
assured consideration, comments and recommendations must be received by
the OMB desk officer via one of the following transmissions: OMB,
Office of Information and Regulatory Affairs, Attention: CMS Desk
Officer, Fax Number: (202) 395-5806 or, Email:
OIRA_submission@omb.eop.gov.
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 https://www.cms.hhs.gov/PaperworkReductionActof1995.
2. Email your request, including your address, phone number, OMB
number, and CMS document identifier, to Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at (410) 786-1326.
FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.
SUPPLEMENTARY INFORMATION: 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 (44 U.S.C. 3506(c)(2)(A)) requires
federal agencies to publish a 30-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 that
summarizes the following proposed collection(s) of information for
public comment:
1. Type of Information Collection Request: Extension of a
previously approved collection; Title of Information Collection:
Medicaid Emergency Psychiatric Demonstration (MEPD) Evaluation; Use:
Since the inception of Medicaid, inpatient care provided to adults ages
21 to 64 in institutions for mental disease (IMDs) has been excluded
from federal matching funds. The Emergency Medical Treatment and Active
Labor Act (EMTALA), however, requires IMDs that participate in Medicare
to provide treatment for psychiatric emergency medical conditions
(EMCs), even for Medicaid patients for whose services cannot be
reimbursed. Section 2707 of the Affordable Care Act (ACA) directs the
Secretary of Health and Human Services to conduct and evaluate a
demonstration project to determine the impact of providing payment
under Medicaid for inpatient services provided by private IMDs to
individuals with emergency psychiatric conditions between the ages of
21 and 64. We will use the data to evaluate the Medicaid Emergency
Psychiatric Demonstration (MEPD) in accordance with the ACA mandates.
This evaluation in turn will be used by Congress to determine whether
to continue or expand the demonstration. If the decision is made to
expand the demonstration, the data collected will help to inform both
CMS and its stakeholders about possible effects of contextual factors
and important procedural issues to consider in the expansion, as well
as the likelihood of various outcomes. Form Number: CMS-10487 (OMB
control number: 0938-NEW); Frequency: Annually; Affected Public:
Individuals and households; State, Local and Tribal governments;
Business and other for-profits and Not-for-profits; Number of
Respondents: 93; Total Annual Responses: 1,944; Total Annual Hours:
2,046. (For policy questions regarding this collection contact Vetisha
McClair at 410-786-4923.)
2. Type of Information Collection Request: Extension of a
previously approved collection; Title of Information Collection:
Quality Improvement Organization (QIO) Assumption of Responsibilities
and Supporting Regulations; Use: The Peer Review Improvement Act of
1982 amended Title XI of the Social Security Act to create the
Utilization and Quality Control Peer Review Organization (PRO) program
which replaces the Professional Standards Review Organization (PSRO)
program and streamlines peer review activities. The term PRO has been
renamed Quality Improvement
[[Page 11223]]
Organization (QIO). This information collection describes the review
functions to be performed by the QIO. It outlines relationships among
QIOs, providers, practitioners, beneficiaries, intermediaries, and
carriers. Form Number: CMS-R-71 (OMB Control Number: 0938-0445);
Frequency: Yearly; Affected Public: Business or other for-profit and
Not-for-profit institutions; Number of Respondents: 6,939; Total Annual
Responses: 489,750; Total Annual Hours: 1,479,346. (For policy
questions regarding this collection contact Tennille Coombs at 410-786-
3472.)
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Collecting
Benefit Coordination Data; Use: This collection of information request
coordinates Part D plan prescription drug coverage with other
prescription drug coverage. The collected information will assist CMS,
Part D plans and other payers with coordination of prescription drug
benefits at the point-of-sale and tracking of the beneficiary's True
out-of-pocket (TrOOP) expenditures using the Part D Transaction
Facilitator (PDTF). Form Number: CMS-10171 (OMB control number: 0938-
0978); Frequency: Yearly and occasionally; Affected Public: Business or
other for-profits; Number of Respondents: 62,438; Total Annual
Responses: 891,777,634; Total Annual Hours: 5,201,718. (For policy
questions regarding this collection contact Shelly Winston at 410-786-
3694.)
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare
Advantage and Prescription Drug Program: Final Marketing Provisions in
42 CFR 422.111(a)(3) and 423.128(a)(3); Use: We require that Medicare
Advantage (MA) organizations and Part D sponsors use standardized
documents to satisfy disclosure requirements mandated by section
1851(d)(3)(A) of the Social Security Act (Act) and 42 CFR 422.111(b)
for MA organizations, and section 1860D-1(c) of the Act and 42 CFR
423.128(a)(3) for Part D sponsors. The regulatory provisions require
that MA organizations and Part D sponsors disclose plan information,
including: Service area, benefits, access, grievance and appeals
procedures, and quality improvement and quality assurance requirements
by September 30th of each year. The MA organizations and Part D
sponsors use the information to comply with the disclosure
requirements. We will use the approved standardized documents to ensure
that correct information is disclosed to current and potential
enrollees.
For 2017, CMS has a total of nine standardized ANOC/EOC documents:
Health Maintenance Organization, Cost, Dual Eligible Special Needs,
Medicare Medical Savings Account, Private-Fee-For-Service, Preferred
Provider Organizations, Preferred Provider Organization with
Prescription Drugs, Health Maintenance Organization with Prescription
Drug, and Prescription Drug. These standardized documents will be used
by MA organizations and Part D sponsors for the 2018 contract year.
In revising the standardized ANOC/EOCs for contract year 2018, we
did not add to or remove any section from the prior contract year ANOC/
EOC models. MA organizations and Part D sponsors are still required to
use the standardized language in the ANOC/EOC models and to send this
document to current members at least 15 days prior to the start of the
annual enrollment period or by September 30, 2017 for the 2018
enrollment season, based on 42 CFR 422.111(a) (3) and 423.128(a)(3).
Form Number: CMS-10260 (OMB control number: 0938-1051); Frequency:
Yearly; Affected Public: Private sector (Business or other for-
profits); Number of Respondents: 805; Total Annual Responses: 805;
Total Annual Hours: 9,660. (For policy questions regarding this
collection contact Gladys Valentin at 410-786-1620.)
5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: CAHPS Home Health
Care Survey; Use: The national implementation of the Home Health Care
Consumer Assessment of Healthcare Providers and Systems (CAHPS[supreg])
Survey is designed to collect ongoing data from samples of home health
care patients who receive skilled services from Medicare-certified home
health agencies. The data collected from the national implementation of
the Home Health Care CAHPS Survey will be used for the following
purposes: (1) To produce comparable data on the patients' perspectives
of the care they receive from home health agencies, (2) to create
incentives for agencies to improve the quality of care they provide
through public reporting of survey results, and (3) to enhance public
accountability in health care by increasing the transparency of the
quality of care provided in return for the public investment. Sampling
and data collection will be conducted on a monthly basis. Survey
results will be analyzed and reported on a quarterly basis, with
publicly reported results based on one year's worth of data.
As part of this information collection request for the national
implementation of Home Health Care CAHPS, CMS is also requesting
approval to conduct a randomized mode experiment with a sample of home
health agencies. The mode experiment compared the responses to the
survey across the three proposed modes to determine whether adjustments
are needed to ensure that the data collection mode does not influence
the survey results. In addition, data from the mode experiment will be
used to determine which, if any, patient characteristics may affect the
patients' rating of the care they receive and, if so, develop an
adjustment model of those data based on those factors. CMS worked with
RTI, the federal contractor to recruit approximately 100 home health
agencies to participate in the mode experiment. The mode experiment
included approximately 23,000 home health care patients. Form Number:
CMS-10275 (OMB control number: 0938-1066); Frequency: Quarterly;
Affected Public: Individuals and households, Business or other for-
profit and Not-for-profit institutions; Number of Respondents:
2,715,890; Total Annual Responses: 2,715,890; Total Annual Hours:
699,440. (For policy questions regarding this collection contact Lori
Teichman at 410-786-6684.)
6. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medication
Therapy Management Program Improvements; Use: Information collected by
Part D medication therapy management programs (as required by the
standardized format for the comprehensive medication review summary)
will be used by beneficiaries or their authorized representatives,
caregivers, and their healthcare providers to improve medication use
and achieve better healthcare outcomes. Form Number: CMS-10396 (OMB
control number 0938-1154); Frequency: Occasionally; Affected Public:
Business or other for-profits; Number of Respondents: 599; Total Annual
Responses: 1,211,661; Total Annual Hours: 807,451. (For policy
questions regarding this collection contact Victoria Dang at 410-786-
3991.)
7. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicaid
Disproportionate Share Hospital (DSH) Annual Reporting Requirements;
Use: States are required to submit an annual report that identifies
each
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disproportionate share hospital (DSH) that received a DSH payment under
the state's Medicaid program in the preceding fiscal year and the
amount of DSH payments paid to that hospital in the same year along
with other information that the Secretary determines necessary to
ensure the appropriateness of DSH payments; Form Number: CMS-R-266 (OMB
control number: 0938-0746); Frequency: Yearly; Affected Public: State,
Local, or Tribal Governments; Number of Respondents: 51; Total Annual
Responses: 51; Total Annual Hours: 2,142. (For policy questions
regarding this collection contact Robert Lane at 410-786-2015.)
Dated: February 15, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2017-03369 Filed 2-17-17; 8:45 am]
BILLING CODE 4120-01-P