Early Retiree Reinsurance Program, 23936-23938 [2013-09541]

Agencies

• Centers for Medicare & Medicaid Services
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 78, Number 78 (Tuesday, April 23, 2013)]
[Notices]
[Pages 23936-23938]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-09541]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-9996-N4]


Early Retiree Reinsurance Program

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: This notice sets forth termination dates for several processes 
under the Early Retiree Reinsurance Program (ERRP) in preparation for 
the January 1, 2014 program sunset date. These operational processes, 
which involve plan sponsors and other parties, include: the submission 
of changes to information in a plan sponsor's ERRP application; the 
reporting of plan sponsor change of ownership; the submission of 
reimbursement requests; the reporting and correction of data 
inaccuracies; and the request for reopenings of reimbursement 
determinations.

DATES: Effective Date: This notice is effective April 19, 2013.

FOR FURTHER INFORMATION CONTACT: David Mlawsky, (410) 786-6851.

SUPPLEMENTARY INFORMATION:

I. Background

    The Patient Protection and Affordable Care Act (Pub. L. 111-148) 
was enacted on March 23, 2010, and the Health Care and Education 
Reconciliation Act of 2010 (Reconciliation Act) (Pub. L. 111-152) was 
enacted on March 30, 2010. These laws are collectively referred to as 
``Affordable Care Act.'' Section 1102 of the Affordable Care Act 
directs the Secretary of Health and Human Services (HHS) to establish 
the temporary Early Retiree Reinsurance Program (ERRP) to provide 
reimbursement to eligible sponsors of employment-based plans for a 
portion of the costs of providing health coverage to early retirees 
(and eligible spouses, surviving spouses, and dependents of such 
retirees), during the period beginning on the date on which the program 
is established, and ending on January 1, 2014 (the ERRP sunset date). 
Section 1102(a)(l) of the Affordable Care Act required the Secretary to 
establish the program

[[Page 23937]]

within 90 days of enactment of the law (by June 21, 2010). Section 
1102(e) of the Affordable Care Act appropriates funding of $5 billion 
for the temporary program.
    In the May 5, 2010 Federal Register (75 FR 24450), we published an 
interim final regulation with comment period, implementing the program 
as of June 1, 2010. Subsequently, we published several guidance 
documents that further detailed program requirements and operations in 
various sections of the rule (see the Regulations and Guidance section 
and the Common Questions section on the ERRP public Web site at 
www.errp.gov). Collectively, the regulations and guidance set forth 
various requirements and processes associated with participation in the 
ERRP. These requirements and processes include mandatory activities, 
such as how to report and correct previously submitted data 
inaccuracies, as well as elective activities, such as requesting a 
reopening of a reimbursement determination.
    Several of these requirements and processes require access to the 
ERRP Secure Web site. The ERRP Secure Web site is used by plan sponsors 
to complete several important operations, such as submitting 
corrections to data inaccuracies and requesting reimbursement. As part 
of ending the program, we are planning for the ERRP Secure Web site to 
eventually be taken offline and archived and to conclude the remaining 
operational processes.
    This notice sets forth the termination dates for several 
operational processes, including those that involve plan sponsors' 
reporting and submitting of information, in preparation for 
implementing the January 1, 2014 sunset date.
    However, this notice does not limit the requirements in the ERRP 
regulations at 45 CFR 149.350, which require plan sponsors (and 
subcontractors, if applicable) to maintain and furnish to the HHS 
Secretary upon request, certain records enumerated in those 
regulations. Such records must be maintained for 6 years after the 
expiration of the plan year in which the costs were incurred, or longer 
if otherwise required by law. These timeframes set forth in 45 CFR 
149.350 continue to apply, notwithstanding the ERRP sunset date or any 
other dates set forth in this notice.

II. Provisions of This Notice

    This notice describes how five operational processes will be 
impacted by the January 1, 2014 sunset date: (1) Reporting changes to 
information in ERRP applications; (2) reporting change of ownership; 
(3) submitting reimbursement requests; (4) reporting and submitting 
corrections to data inaccuracies; and (5) requesting the Secretary to 
reopen and revise an adverse reimbursement determination. Presented 
below are the specifics of how these operational processes will be 
impacted.

A. Date After Which Plan Sponsors No Longer Must Report Changes to 
Information in Their ERRP Applications

    The ERRP regulations at 45 CFR 149.35 require a plan sponsor that 
wishes to participate in the ERRP to submit an application to the 
Secretary, in the manner and at the time required by the Secretary, as 
specified in 45 CFR 149.40. The application must contain all the 
information specified in 45 CFR 149.40 to be approved. Currently, a 
plan sponsor with an approved application is required to report updates 
to information contained in its application.\1\ CMS expects plan 
sponsors to update by December 31, 2013, all information that they know 
is inaccurate. Contact and banking information should be updated in the 
ERRP Secure Web site.
---------------------------------------------------------------------------

    \1\ See Common Question 100-8, under the Application tab in the 
Common Questions section of www.errp.gov.
---------------------------------------------------------------------------

    All other application information should be updated by amendment of 
the paper ERRP application. After December 31, 2013, plan sponsors will 
no longer be required to update information contained in either their 
paper application or the ERRP Secure Web site. Any plan sponsor that is 
the subject of an active audit as of December 31, 2013, still will be 
required to keep both CMS and the ERRP Program Integrity Contractor 
informed of the most current contact information for their Authorized 
Representative, Account Manager, and any other critical points of 
contact, until such time that the audit is completed. The plan sponsor 
must communicate changes to contact information by phone call or email 
to the ERRP Contact Center and ERRP Program Integrity Contractor.

B. Date After Which Plan Sponsors No Longer Must Report Change of 
Ownership

    The ERRP regulations at 45 CFR 149.700 define change of ownership, 
and require plan sponsors that are considering or negotiating a change 
of ownership to notify the Secretary at least 60 days before the 
anticipated effective date of the change. In preparation for the ERRP 
sunset date, a plan sponsor need not notify the Secretary of any such 
change of ownership in instances where the anticipated effective date 
of the change would occur after December 31, 2013.

C. Last Date Plan Sponsors May Submit Reimbursement Requests

    The ERRP regulations at 45 CFR 149.300 state: ``Reimbursement under 
this program is conditioned upon the provision of accurate information 
by the plan sponsor or its designee. The information must be submitted, 
in a form and manner and at the times provided in this subpart and 
other guidance specified by the Secretary.'' In various guidance 
documents published on www.errp.gov, CMS specified the form, manner, 
and times for submitting reimbursement requests. As part of ending the 
program, we are planning for the ERRP Secure Web site to eventually be 
taken offline and archived, and to conclude the remaining operational 
processes. In preparation for the ERRP sunset date, the last day upon 
which a plan sponsor may submit an ERRP reimbursement request is July 
31, 2013.\2\ This termination date will allow for a phase down of ERRP 
operational processes related to the ERRP Secure Web site.
---------------------------------------------------------------------------

    \2\ To meet this deadline, a plan sponsor must take into account 
the timeframe it may take to submit a new Early Retiree List (if its 
most recent one has expired), an error-free Claim List, and a 
Reimbursement Request. A plan sponsor must also take into account 
the timeframes for CMS to make available to the plan sponsor an 
Early Retiree List Response File (up to 7 business days), and a 
Claim List Response File (2-4 calendar days). See all relevant 
training and guidance materials at www.errp.gov.
---------------------------------------------------------------------------

D. Date After Which Plan Sponsors Are No Longer Required To Submit 
Corrections to Data Inaccuracies

    The ERRP regulations at 45 CFR 149.600 state: ``A sponsor is 
required to disclose any data inaccuracies upon which a reimbursement 
determination is made, including inaccurate claims data and negotiated 
price concessions, in a manner and at a time specified by the Secretary 
in guidance.'' CMS specified the form, manner, and times for submitting 
corrections to data inaccuracies in various guidance documents 
published on www.errp.gov. The primary guidance document setting forth 
how plan sponsors must correct data inaccuracies states that plan 
sponsors must submit a reimbursement request that includes corrected 
data, no later than the end of the next calendar quarter after the plan 
sponsor knows, or should know, of the data inaccuracy.\3\

[[Page 23938]]

Because the process for submitting corrections to data inaccuracies 
leverages the process for submitting reimbursement requests, we have 
concluded that plan sponsors will no longer be required to submit 
corrections to data inaccuracies after July 31, 2013, that is, the last 
day upon which a plan sponsor may submit an ERRP reimbursement request. 
This means that plan sponsors that know or should know, before or on 
April 30, 2013, of any data inaccuracy contained in a reimbursement 
request for a plan year for which a reimbursement determination was 
made, must submit corrections to the data inaccuracy in a manner 
consistent with the ERRP regulations and guidance.\4\ A plan sponsor 
that does not know with certainty its final amount of price concessions 
for a given plan year, but knows or should know, as of April 30, 2013, 
of estimates that vary from previously reported price concession 
amounts for that plan year, must consider those previous amounts to 
constitute data inaccuracies, and therefore is required to report and 
correct that data by July 31, 2013.
---------------------------------------------------------------------------

    \3\ See Explanation of the Processes for Reporting Early Retiree 
and Claims Data Inaccuracies, and for Reopening, under the 
Regulations and Guidance section at www.errp.gov.
    \4\ See footnotes 2 and 3. However, as discussed above, a 
sponsor that knows or should know, before or on April 30, 2013, of 
any data inaccuracy contained in a reimbursement request for a plan 
year for which a reimbursement determination was made, must submit a 
reimbursement request with corrected data by July 31, 2013, rather 
than by no later than the end of the next calendar quarter after the 
sponsor knows or should know of the data inaccuracy.
---------------------------------------------------------------------------

E. Last Day Plan Sponsors May Submit a Request To Reopen and Revise an 
Adverse Reimbursement Determination

    The ERRP regulations at 45 CFR 149.610 permit the Secretary to 
reopen and revise a reimbursement determination upon the Secretary's 
own motion or upon the request of a plan sponsor. The regulations, as 
well as guidance published on www.errp.gov,\5\ set forth the process by 
which a plan sponsor may request a reopening, as well as other 
information related to reopenings. In preparation for the ERRP sunset 
date, the last day upon which a plan sponsor may submit an ERRP 
reopening request is December 31, 2013.
---------------------------------------------------------------------------

    \5\ See footnote 3.
---------------------------------------------------------------------------

III. Collection of Information Requirements

    Under the Paperwork Reduction Act of 1995, we are required to 
provide 60-day notice in the Federal Register and solicit public 
comment before a collection of information requirement is submitted to 
the Office of Management and Budget (OMB) for review and approval. The 
information collection requirements associated with the ERRP are 
currently approved under OMB control number 0938-1087, with an 
expiration date of September 30, 2014. This document does not impose 
any new information collection and recordkeeping requirements beyond 
the prior estimates in the supporting statement for the interim final 
rule, CMS-9995-IFC. Consequently, it need not be reviewed by the Office 
of Management and Budget under the authority of the Paperwork Reduction 
Act of 1995.

    Authority:  Sections 1102(a)(l) of the Affordable Care Act (42 
U.S.C. Sec.  18002(a)(l) and(c)(4)).

    Dated: April 16, 2013.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2013-09541 Filed 4-19-13; 11:15 am]
BILLING CODE 4120-01-P