Request for Information Regarding the Reinsurance Program Under the Affordable Care Act, 4564-4566 [2012-1944]
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4564
Federal Register / Vol. 77, No. 19 / Monday, January 30, 2012 / Notices
Desk Officer. Fax Number: (202) 395–
6974.
Email:
OIRA_submission@omb.eop.gov.
Dated: January 24, 2012.
Martique Jones,
Director, Regulations Development Group,
Division-B, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2012–1945 Filed 1–27–12; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier CMS–855I and CMS–
855R]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services.
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) 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 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.
1. Type of Information Collection
Request: Revision of a currently
approved collection. Title of
Information Collection: Medicare
Enrollment Application for Physician
and Non-Physician Practitioners. Use:
Health care practitioners who wish to
enroll in the Medicare program must
complete the CMS 855I enrollment
application. It is submitted at the time
the applicant first requests a Medicare
billing number. The application is used
by the Medicare Administrative
Contractor (MAC), to collect data to
assure the applicant has the necessary
professional and/or business credentials
to provide the health care services for
which they intend to bill Medicare
emcdonald on DSK29S0YB1PROD with NOTICES
AGENCY:
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Jkt 226001
including information that allows the
MAC to correctly price, process and pay
the applicant’s claims. It also gathers
information that allows the MAC to
ensure that the practitioner is not
sanctioned from the Medicare program,
or debarred, suspended or excluded
from any other Federal agency or
program. Form Number: CMS–855I
(OCN 0938–0685). Frequency: Once and
Occasionally. Affected Public: Private
Sector (Business or other for-profit and
not-for-profit institutions). Number of
Respondents: 345,000. Total Annual
Responses: 345,000. Total Annual
Hours: 824,000. (For policy questions
regarding this collection contact
Kimberly McPhillips at (410) 786–5374.
For all other issues call (410) 786–1326.)
2. Type of Information Collection
Request: New collection. Title of
Information Collection: Medicare
Enrollment Application—Reassignment
of Medicare Benefits. Use: Health care
practitioners who wish to reassign their
benefits in the Medicare program must
complete the CMS 855R enrollment
application. It is submitted at the time
the physician or non-physician
practitioner first requests reassignment
of his/her Medicare benefits to a group
practice, as well as any subsequent
reassignments or terminations of
established reassignments as requested
by the physician or non-physician
practitioner. The application is used by
the Medicare Administrative Contractor
(MAC) to collect data to assure the
applicant has the necessary information
that allows the MAC to correctly
establish or terminate the reassignment.
Form Number: CMS–855R (OCN 0938New). Frequency: Occasionally.
Affected Public: Private Sector (Business
or other for-profit and not-for-profit
institutions). Number of Respondents:
100,000. Total Annual Responses:
100,000. Total Annual Hours: 50,000.
(For policy questions regarding this
collection contact Kimberly McPhillips
at (410) 786–5374. 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 https://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 at (410) 786–
1326.
In commenting on the proposed
information collections please reference
the document identifier or OMB control
number. To be assured consideration,
comments and recommendations must
PO 00000
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Fmt 4703
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be submitted in one of the following
ways by March 30, 2012:
1. Electronically. You may submit
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) 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 llllRoom C4–26–
05, 7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: January 24, 2012.
Martique Jones,
Director, Regulations Development Group,
Division B, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2012–1951 Filed 1–27–12; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–9970–NC]
Request for Information Regarding the
Reinsurance Program Under the
Affordable Care Act
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Request for information.
AGENCY:
This notice is a request for
information (RFI) to gain market
information on entities that could
administer a transitional reinsurance
program. This RFI will inform one or
more future Requests for Proposals
(RFP). This RFI solicits information
about entities that could function as a
reinsurance entity for the transitional
reinsurance program. CMS or one or
more States may contract for services
required to fulfill the statutory and
regulatory requirements of the
reinsurance entity.
DATES: Submit written or electronic
comments by February 29, 2012.
ADDRESSES: In responding, please refer
to file code CMS–9970–NC. Because of
staff and resource limitations, we cannot
accept comments by facsimile (FAX)
transmission.
You may submit responses in one of
four ways (please choose only one of the
ways listed):
1. Electronically. You may submit
electronic comments on this regulation
SUMMARY:
E:\FR\FM\30JAN1.SGM
30JAN1
Federal Register / Vol. 77, No. 19 / Monday, January 30, 2012 / Notices
emcdonald on DSK29S0YB1PROD with NOTICES
to https://www.regulations.gov. Follow
the instructions under the ‘‘More Search
Options’’ tab.
2. By regular mail. You may mail
written comments to the following
address ONLY: Centers for Medicare &
Medicaid Services, Department of
Health and Human Services, Attention:
CMS–9970–NC, P.O. Box 8016,
Baltimore, MD 21244–8016.
Please allow sufficient time for mailed
comments to be received before the
close of the comment period.
3. By express or overnight mail. You
may send written comments to the
following address ONLY: Centers for
Medicare & Medicaid Services,
Department of Health and Human
Services, Attention: CMS–9970–NC,
Mail Stop C4–26–05, 7500 Security
Boulevard, Baltimore, MD 21244–1850.
4. By hand or courier. If you prefer,
you may deliver (by hand or courier)
your written comments before the close
of the comment period to either of the
following addresses:
a. For delivery in Washington, DC—
Centers for Medicare & Medicaid
Services, Department of Health and
Human Services, Room 445–G, Hubert
H. Humphrey Building, 200
Independence Avenue SW.,
Washington, DC 20201.
(Because access to the interior of the
Hubert H. Humphrey Building is not
readily available to persons without
Federal government identification,
commenters are encouraged to leave
their comments in the CMS drop slots
located in the main lobby of the
building. A stamp-in clock is available
for persons wishing to retain a proof of
filing by stamping in and retaining an
extra copy of the comments being filed.)
b. For delivery in Baltimore, MD—
Centers for Medicare & Medicaid
Services, Department of Health and
Human Services, 7500 Security
Boulevard, Baltimore, MD 21244–
1850.
If you intend to deliver your
comments to the Baltimore address,
please call telephone number (410) 786–
9994 in advance to schedule your
arrival with one of our staff members.
Comments mailed to the addresses
indicated as appropriate for hand or
courier delivery may be delayed and
received after the comment period.
For information on viewing public
comments, see the beginning of the
SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT:
Milan Shah, (301) 492–4427.
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments: All
comments received before the close of
VerDate Mar<15>2010
15:09 Jan 27, 2012
Jkt 226001
the comment period are available for
viewing by the public, including any
personally identifiable or confidential
business information that is included in
a comment. We post all comments
received before the close of the
comment period on the following Web
site as soon as possible after they have
been received: https://
www.regulations.gov. Follow the search
instructions on that Web site to view
public comments.
Comments received timely will also
be available for public inspection as
they are received, generally beginning
approximately 3 weeks after publication
of a document, at the headquarters of
the Centers for Medicare & Medicaid
Services, 7500 Security Boulevard,
Baltimore, Maryland 21244, Monday
through Friday of each week from 8:30
a.m. to 4 p.m. To schedule an
appointment to view public comments,
phone 1–(800) 743–3951.
We note that responses to this RFI are
not offers, and cannot be accepted by
the Government to form a binding
contract or to issue a grant. The purpose
of this RFI is to inform one or more
Requests for Proposals, not to gather
public comments on the proposed rules
for reinsurance, risk corridors, or risk
adjustment under the Affordable Care
Act. Those comments have been
collected and are being evaluated
separately. Information obtained in
response to this RFI may be used by the
Government for program planning and
development, or other purposes with or
without attribution. Do not include any
information that might be considered
proprietary or confidential.
I. Background
Section 1341 of the Patient Protection
and Affordable Care Act (Pub. L. 111–
148, enacted on March 23, 2010) (the
Affordable Care Act), provides that each
State must establish a transitional
reinsurance program to help stabilize
premiums for coverage in the individual
market during the first three years of
Exchange operation (2014–2016). The
reinsurance program, which is a Statebased program, will reduce the
uncertainty of insurance risk in the
individual market by making payments
for high-cost cases. This program will
stabilize individual market rate
increases that might otherwise occur
because of the immediate enrollment of
individuals with unknown health
status, potentially including, at the
State’s discretion, those currently in
State high-risk pools. CMS published
proposed rules for States and health
insurance issuers for this reinsurance
program on July 15, 2011 (76 FR 41930).
PO 00000
Frm 00025
Fmt 4703
Sfmt 4703
4565
The Affordable Care Act instructs
each State to establish or contract with
an entity to carry out the reinsurance
program. Section 1321(c)(1) of the
Affordable Care Act directs the
Secretary to take such actions as are
necessary to implement the reinsurance
program in a State if a State has not
taken action necessary to do so. The
reinsurance entity, whether operating
under contract with a State or CMS,
must be a not-for-profit organization
with a tax-exempt status.
II. Request for Information
This RFI seeks comment on the
entities that could carry out the
transitional reinsurance program. CMS
may enter into one or more contracts to
fulfill the statutory and regulatory
requirements of the transitional
reinsurance program established under
section 1341 of the Affordable Care Act
depending on the workload and number
of States that would require assistance.
In such a case, the contractor may be
tasked with one or more of the following
functions:
• Collecting reinsurance
contributions;
• Accepting and validating requests
for reinsurance payments;
• Remitting reinsurance payments;
• Reconciling and verifying
reinsurance contributions and
payments;
• Maintaining records; and,
• Providing customer support to
issuers.
CMS is seeking to engage formally, in
a transparent and participatory manner,
with entities that understand the
reinsurance market, and would be able
to perform the responsibilities of a
reinsurance entity under the statute and
associated regulations. In carrying out
the transitional reinsurance program,
CMS seeks to mitigate conflicts of
interest (COIs) that may arise if potential
market competitors operate the
reinsurance program. As such, we
request any information on potential
COIs, and potential avenues for
mitigation, from all stakeholders,
including issuers and third-party
administrators.
Infrastructure
1. Does your organization operate as
a not-for-profit reinsurance entity in the
State(s) in which you currently conduct
business?
2. If your organization operates as a
reinsurance entity but does not function
as a not-for-profit, what steps would
have to be taken to convert the
organization or the part of that
organization responsible for reinsurance
operations into a not-for-profit entity?
E:\FR\FM\30JAN1.SGM
30JAN1
4566
Federal Register / Vol. 77, No. 19 / Monday, January 30, 2012 / Notices
What other considerations should be
taken into account in connection with
such a conversion?
3. What other steps must your
organization take in order to be
prepared to smoothly transition into a
role as administrator of a new temporary
reinsurance program?
4. Does your organization operate
nationally or in limited geographic
areas? If the latter, what are the
geographic areas?
5. Would your organization be able
and willing to contract with a State
and/or the Federal government to
operate a temporary reinsurance
program?
6. Are there any State and/or local
licensing requirements that must be
considered by an organization operating
as such a reinsurance entity?
7. What potential conflicts of interest
(COIs) could arise if your organization
were to operate such a reinsurance
program as a not-for-profit entity? How
might these COIs be mitigated?
8. For organizations that do not
currently have COI mitigation programs,
what steps would have to be taken to
develop and execute such a program?
9. What is a reasonable amount of
time for your organization to become
fully operational (for example, have all
systems in place to operate a
reinsurance program) after the date of a
contract award? What resources would
be necessary?
emcdonald on DSK29S0YB1PROD with NOTICES
Collection and Disbursement of
Reinsurance Funds
10. Describe your organization’s
ability to perform the following
functions:
• Collecting reinsurance
contributions;
• Accepting and validating requests
for reinsurance payments;
• Remitting reinsurance payments;
and,
• Reconciling and verifying
reinsurance contributions and
payments.
11. What services related to the
collection of reinsurance contributions,
or disbursement of reinsurance
payments to another entity would your
organization need to subcontract due to
a lack of capacity, expertise, or
experience?
12. What COIs could arise for such
potential subcontractors?
Data Collection
13. Describe current data systems that
are used by your organization, including
any standards, security systems, and
web-based interactive structure. Are
your systems compliant or have the
capability of being Section 508
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15:09 Jan 27, 2012
Jkt 226001
compliant (https://www.section508.
gov/)?
14. Do your organization’s current
data systems have the capability to
interface with external systems to accept
data and reports? If yes, what types of
interfaces are currently in place?
15. What data are currently collected
by your organization related to medical
costs?
16. What is your organization’s
current capacity for collecting and
verifying claims submissions from
issuers? What processes does your
organization have in place to ensure
confidentiality and security protections
of patient information?
17. In what formats does your
organization currently collect data? Can
your organization support other
formats? If so, which ones?
18. Would your organization need to
subcontract any services related to data
collection?
19. What COIs could arise for such
subcontractors?
Customer Support
20. What telecommunication and
technical support systems does your
organization currently maintain for
health insurance issuers or other
commercial clients (for example, Web
sites, 24-hour hotlines, helpdesk)?
21. Are your support systems
compliant or have the capability of
being Section 508 compliant (https://
www.section508.gov/)?
22. Would your organization need to
subcontract any services related to data
collection?
23. What COIs could arise for such
subcontractors?
Evaluation
24. Does your organization currently
conduct evaluations of operations and
activities? Do such evaluations include
a financial assessment of your
organization’s activities?
25. What are your organization’s
current financial and data reconciliation
processes?
Authority: Catalog of Federal Domestic
Assistance Program No. 93.773, Medicare—
Hospital Insurance; and Program No. 93.774,
Medicare—Supplementary Medical
Insurance Program.
Dated: January 20, 2012.
Charles Littleton,
Contracting Officer, Office of Acquisition and
Grants Management, Centers for Medicare
and Medicaid Services.
[FR Doc. 2012–1944 Filed 1–27–12; 8:45 am]
BILLING CODE 4120–01–P
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2012–N–0001]
Pulmonary-Allergy Drugs Advisory
Committee; Notice of Meeting
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
This notice announces a forthcoming
meeting of a public advisory committee
of the Food and Drug Administration
(FDA). The meeting will be open to the
public.
Name of Committee: PulmonaryAllergy Drugs Advisory Committee.
General Function of the Committee:
To provide advice and
recommendations to the Agency on
FDA’s regulatory issues.
Date and Time: The meeting will be
held on February 23, 2012, from 8:30
a.m. to 5 p.m.
Location: FDA White Oak Campus,
10903 New Hampshire Ave., Bldg. 31
Conference Center, the Great Room (rm.
1503), Silver Spring MD 20993–0002.
Information regarding special
accommodations due to a disability,
visitor parking, and transportation may
be accessed at https://www.fda.gov/
AdvisoryCommittees/default.htm; under
the heading ‘‘Resources for You’’, click
on ‘‘Public Meetings at the FDA White
Oak Campus.’’ Please note that visitors
to the White Oak Campus must enter
through Building 1.
Contact Person: Nicole Vesely, Center
for Drug Evaluation and Research, Food
and Drug Administration, 10903 New
Hampshire Ave., Bldg. 31, rm. 2417,
Silver Spring, MD 20993–0002, (301)
796–9001, Fax: (301) 847–8533, email:
PADAC@fda.hhs.gov, or FDA Advisory
Committee Information Line, 1-(800)
741–8138 (301) 443–0572 in the
Washington, DC area), and follow the
prompts to the desired center or product
area. Please call the Information Line for
up-to-date information on this meeting.
A notice in the Federal Register about
last minute modifications that impact a
previously announced advisory
committee meeting cannot always be
published quickly enough to provide
timely notice. Therefore, you should
always check the Agency’s Web site and
call the appropriate advisory committee
hot line/phone line to learn about
possible modifications before coming to
the meeting.
Agenda: The committee will discuss
new drug application 202450, for
aclidinium bromide, sponsored by
Forest Laboratories, for the proposed
E:\FR\FM\30JAN1.SGM
30JAN1
Agencies
[Federal Register Volume 77, Number 19 (Monday, January 30, 2012)]
[Notices]
[Pages 4564-4566]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-1944]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-9970-NC]
Request for Information Regarding the Reinsurance Program Under
the Affordable Care Act
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Request for information.
-----------------------------------------------------------------------
SUMMARY: This notice is a request for information (RFI) to gain market
information on entities that could administer a transitional
reinsurance program. This RFI will inform one or more future Requests
for Proposals (RFP). This RFI solicits information about entities that
could function as a reinsurance entity for the transitional reinsurance
program. CMS or one or more States may contract for services required
to fulfill the statutory and regulatory requirements of the reinsurance
entity.
DATES: Submit written or electronic comments by February 29, 2012.
ADDRESSES: In responding, please refer to file code CMS-9970-NC.
Because of staff and resource limitations, we cannot accept comments by
facsimile (FAX) transmission.
You may submit responses in one of four ways (please choose only
one of the ways listed):
1. Electronically. You may submit electronic comments on this
regulation
[[Page 4565]]
to https://www.regulations.gov. Follow the instructions under the ``More
Search Options'' tab.
2. By regular mail. You may mail written comments to the following
address ONLY: Centers for Medicare & Medicaid Services, Department of
Health and Human Services, Attention: CMS-9970-NC, P.O. Box 8016,
Baltimore, MD 21244-8016.
Please allow sufficient time for mailed comments to be received
before the close of the comment period.
3. By express or overnight mail. You may send written comments to
the following address ONLY: Centers for Medicare & Medicaid Services,
Department of Health and Human Services, Attention: CMS-9970-NC, Mail
Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.
4. By hand or courier. If you prefer, you may deliver (by hand or
courier) your written comments before the close of the comment period
to either of the following addresses:
a. For delivery in Washington, DC--Centers for Medicare & Medicaid
Services, Department of Health and Human Services, Room 445-G, Hubert
H. Humphrey Building, 200 Independence Avenue SW., Washington, DC
20201.
(Because access to the interior of the Hubert H. Humphrey Building
is not readily available to persons without Federal government
identification, commenters are encouraged to leave their comments in
the CMS drop slots located in the main lobby of the building. A stamp-
in clock is available for persons wishing to retain a proof of filing
by stamping in and retaining an extra copy of the comments being
filed.)
b. For delivery in Baltimore, MD--Centers for Medicare & Medicaid
Services, Department of Health and Human Services, 7500 Security
Boulevard, Baltimore, MD 21244-1850.
If you intend to deliver your comments to the Baltimore address,
please call telephone number (410) 786-9994 in advance to schedule your
arrival with one of our staff members.
Comments mailed to the addresses indicated as appropriate for hand
or courier delivery may be delayed and received after the comment
period.
For information on viewing public comments, see the beginning of
the SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT: Milan Shah, (301) 492-4427.
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments: All comments received before the
close of the comment period are available for viewing by the public,
including any personally identifiable or confidential business
information that is included in a comment. We post all comments
received before the close of the comment period on the following Web
site as soon as possible after they have been received: https://www.regulations.gov. Follow the search instructions on that Web site to
view public comments.
Comments received timely will also be available for public
inspection as they are received, generally beginning approximately 3
weeks after publication of a document, at the headquarters of the
Centers for Medicare & Medicaid Services, 7500 Security Boulevard,
Baltimore, Maryland 21244, Monday through Friday of each week from 8:30
a.m. to 4 p.m. To schedule an appointment to view public comments,
phone 1-(800) 743-3951.
We note that responses to this RFI are not offers, and cannot be
accepted by the Government to form a binding contract or to issue a
grant. The purpose of this RFI is to inform one or more Requests for
Proposals, not to gather public comments on the proposed rules for
reinsurance, risk corridors, or risk adjustment under the Affordable
Care Act. Those comments have been collected and are being evaluated
separately. Information obtained in response to this RFI may be used by
the Government for program planning and development, or other purposes
with or without attribution. Do not include any information that might
be considered proprietary or confidential.
I. Background
Section 1341 of the Patient Protection and Affordable Care Act
(Pub. L. 111-148, enacted on March 23, 2010) (the Affordable Care Act),
provides that each State must establish a transitional reinsurance
program to help stabilize premiums for coverage in the individual
market during the first three years of Exchange operation (2014-2016).
The reinsurance program, which is a State-based program, will reduce
the uncertainty of insurance risk in the individual market by making
payments for high-cost cases. This program will stabilize individual
market rate increases that might otherwise occur because of the
immediate enrollment of individuals with unknown health status,
potentially including, at the State's discretion, those currently in
State high-risk pools. CMS published proposed rules for States and
health insurance issuers for this reinsurance program on July 15, 2011
(76 FR 41930).
The Affordable Care Act instructs each State to establish or
contract with an entity to carry out the reinsurance program. Section
1321(c)(1) of the Affordable Care Act directs the Secretary to take
such actions as are necessary to implement the reinsurance program in a
State if a State has not taken action necessary to do so. The
reinsurance entity, whether operating under contract with a State or
CMS, must be a not-for-profit organization with a tax-exempt status.
II. Request for Information
This RFI seeks comment on the entities that could carry out the
transitional reinsurance program. CMS may enter into one or more
contracts to fulfill the statutory and regulatory requirements of the
transitional reinsurance program established under section 1341 of the
Affordable Care Act depending on the workload and number of States that
would require assistance. In such a case, the contractor may be tasked
with one or more of the following functions:
Collecting reinsurance contributions;
Accepting and validating requests for reinsurance
payments;
Remitting reinsurance payments;
Reconciling and verifying reinsurance contributions and
payments;
Maintaining records; and,
Providing customer support to issuers.
CMS is seeking to engage formally, in a transparent and
participatory manner, with entities that understand the reinsurance
market, and would be able to perform the responsibilities of a
reinsurance entity under the statute and associated regulations. In
carrying out the transitional reinsurance program, CMS seeks to
mitigate conflicts of interest (COIs) that may arise if potential
market competitors operate the reinsurance program. As such, we request
any information on potential COIs, and potential avenues for
mitigation, from all stakeholders, including issuers and third-party
administrators.
Infrastructure
1. Does your organization operate as a not-for-profit reinsurance
entity in the State(s) in which you currently conduct business?
2. If your organization operates as a reinsurance entity but does
not function as a not-for-profit, what steps would have to be taken to
convert the organization or the part of that organization responsible
for reinsurance operations into a not-for-profit entity?
[[Page 4566]]
What other considerations should be taken into account in connection
with such a conversion?
3. What other steps must your organization take in order to be
prepared to smoothly transition into a role as administrator of a new
temporary reinsurance program?
4. Does your organization operate nationally or in limited
geographic areas? If the latter, what are the geographic areas?
5. Would your organization be able and willing to contract with a
State and/or the Federal government to operate a temporary reinsurance
program?
6. Are there any State and/or local licensing requirements that
must be considered by an organization operating as such a reinsurance
entity?
7. What potential conflicts of interest (COIs) could arise if your
organization were to operate such a reinsurance program as a not-for-
profit entity? How might these COIs be mitigated?
8. For organizations that do not currently have COI mitigation
programs, what steps would have to be taken to develop and execute such
a program?
9. What is a reasonable amount of time for your organization to
become fully operational (for example, have all systems in place to
operate a reinsurance program) after the date of a contract award? What
resources would be necessary?
Collection and Disbursement of Reinsurance Funds
10. Describe your organization's ability to perform the following
functions:
Collecting reinsurance contributions;
Accepting and validating requests for reinsurance
payments;
Remitting reinsurance payments; and,
Reconciling and verifying reinsurance contributions and
payments.
11. What services related to the collection of reinsurance
contributions, or disbursement of reinsurance payments to another
entity would your organization need to subcontract due to a lack of
capacity, expertise, or experience?
12. What COIs could arise for such potential subcontractors?
Data Collection
13. Describe current data systems that are used by your
organization, including any standards, security systems, and web-based
interactive structure. Are your systems compliant or have the
capability of being Section 508 compliant (https://www.section508. gov/
)?
14. Do your organization's current data systems have the capability
to interface with external systems to accept data and reports? If yes,
what types of interfaces are currently in place?
15. What data are currently collected by your organization related
to medical costs?
16. What is your organization's current capacity for collecting and
verifying claims submissions from issuers? What processes does your
organization have in place to ensure confidentiality and security
protections of patient information?
17. In what formats does your organization currently collect data?
Can your organization support other formats? If so, which ones?
18. Would your organization need to subcontract any services
related to data collection?
19. What COIs could arise for such subcontractors?
Customer Support
20. What telecommunication and technical support systems does your
organization currently maintain for health insurance issuers or other
commercial clients (for example, Web sites, 24-hour hotlines,
helpdesk)?
21. Are your support systems compliant or have the capability of
being Section 508 compliant (https://www.section508.gov/)?
22. Would your organization need to subcontract any services
related to data collection?
23. What COIs could arise for such subcontractors?
Evaluation
24. Does your organization currently conduct evaluations of
operations and activities? Do such evaluations include a financial
assessment of your organization's activities?
25. What are your organization's current financial and data
reconciliation processes?
Authority: Catalog of Federal Domestic Assistance Program No.
93.773, Medicare--Hospital Insurance; and Program No. 93.774,
Medicare--Supplementary Medical Insurance Program.
Dated: January 20, 2012.
Charles Littleton,
Contracting Officer, Office of Acquisition and Grants Management,
Centers for Medicare and Medicaid Services.
[FR Doc. 2012-1944 Filed 1-27-12; 8:45 am]
BILLING CODE 4120-01-P