Agency Information Collection Activities: Proposed Collection; Comment Request, 45205-45208 [2013-17985]

Download as PDF tkelley on DSK3SPTVN1PROD with NOTICES Federal Register / Vol. 78, No. 144 / Friday, July 26, 2013 / Notices Respondents: 6,171; Total Annual Responses: 6,171; Total Annual Hours: 4,153,083. (For policy questions regarding this collection contact Nadia Massuda at 410–786–5834.) 8. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: Medicare Part D Reporting Requirements; Use: Title I, Part 423, § 423.514 describes our regulatory authority to establish reporting requirements for Part D sponsors. It is noted that each Part D plan sponsor must have an effective procedure to develop, compile, evaluate, and report to us, to its enrollees, and to the general public, at the times and in the manner that we requires, statistics in the following areas: the cost of its operations; the patterns of utilization of its services; the availability, accessibility, and acceptability of its services; information demonstrating that the Part D plan sponsor has a fiscally sound operation; and other matters that we may require. CMS has identified the appropriate data needed to effectively monitor plan performance. Changes to the currently approved data collection instrument reflect new executive orders, legislation, as well as recent changes to Agency policy and guidance. Form Number: CMS–10185 (OCN: 0938–0992); Frequency: Occasionally; Affected Public: Business and other for-profits; Number of Respondents: 690; Total Annual Responses: 8,067; Total Annual Hours: 12,658. (For policy questions regarding this collection contact Latoyia Grant at 410–786–5434.) 9. Type of Information Collection Request: New collection (Request for a new OMB control number); Title of Information Collection: Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Exchanges; Use: Section 1311(i) of the Affordable Care Act requires Exchanges to establish a Navigator grant program as part of its function to provide consumers with assistance when they need it. Navigators will assist consumers by providing education about and facilitating selection of qualified health plans (QHPs) within Exchanges, as well as other required duties. Section 1311(i) requires that an Exchange operating as of January 1, 2014, must establish a Navigator Program under which it awards grants to eligible individuals or entities who satisfy the requirements to be Exchange Navigators. For Federallyfacilitated Exchanges (FFE) and State Partnership Exchanges (SPEs), we will be awarding the grants. Navigator awardees must provide quarterly, bi- VerDate Mar<15>2010 18:54 Jul 25, 2013 Jkt 229001 annual, and an annual progress report to us on the activities performed during the grant period and any sub-awardees receiving funds. The 60-day Federal Register notice was published on April 12, 2013 (78 FR 21957). Several commenters suggested changes to the reporting requirements which were incorporated where appropriate. Form Number: CMS–10463 (OCN: 0938– NEW); Frequency: Annually, Quarterly; Affected Public: Private sector; Number of Respondents: 264; Total Annual Responses: 1,848; Total Annual Hours: 308,352. (For policy questions regarding this collection contact Holly Whelan at 301–492–4220.) Dated: July 23, 2013. Martique Jones, Deputy Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2013–18004 Filed 7–25–13; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifiers: CMS–10326, CMS– 10487, CMS–P–0015A, CMS–R–10, CMS–R– 240, CMS–10282, CMS–R–65 and CMS– 10491] Agency Information Collection Activities: Proposed Collection; Comment Request Centers for Medicare & Medicaid Services, HHS. 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 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 SUMMARY: PO 00000 Frm 00037 Fmt 4703 Sfmt 4703 45205 automated collection techniques or other forms of information technology to minimize the information collection burden. Comments must be received by September 24, 2013: ADDRESSES: When commenting, please reference the document identifier or OMB control number (OCN). 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 ____, 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–10326 Electronic Submission of Medicare Graduate Medical Education (GME) Affiliation Agreements CMS–10487 Medicaid Emergency Psychiatric Demonstration (MEPD) Evaluation CMS–P–0015A Medicare Current Beneficiary Survey CMS–R–10 Advance Directives (Medicare and Medicaid) and Supporting Regulations E:\FR\FM\26JYN1.SGM 26JYN1 45206 Federal Register / Vol. 78, No. 144 / Friday, July 26, 2013 / Notices tkelley on DSK3SPTVN1PROD with NOTICES CMS–R–240 Prospective Payments for Hospital Outpatient Services and Supporting Regulations CMS–10282 Conditions of Participation for Comprehensive Outpatient Rehabilitation Facilities (CORFs) and supporting regulations CMS–R–65 Final Peer Review Organizations Sanction Regulations in 42 CFR Sections 1004.40, 1004.50, 1004.60, and 1004.70 CMS–10491 Enrollment Assistance Program Under the Paperwork Reduction Act (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 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 Collections 1. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Electronic Submission of Medicare Graduate Medical Education (GME) Affiliation Agreements; Use: We use the information contained in electronic affiliation agreements as documentation of the existence of Medicare GME affiliations, and to verify that the affiliations being formed by teaching hospitals for the purposes of sharing their Medicare Graduate Medical Education FTE cap slots are valid according to CMS regulations. The affiliation agreements are also used as reference materials when potential issues involving specific affiliations arise. Form Number: CMS–10326 (OCN: 0938–1111); Frequency: Yearly; Affected Public: Private sector—Business or other for-profits and Not-for-profit institutions; Number of Respondents: 125; Total Annual Responses: 125; Total Annual Hours: 166. (For policy questions regarding this collection contact Tzvi Hefter at 410–786–0614.) 2. Type of Information Collection Request: New Collection (Request for a new OMBcontrol number); Title of Information Collection: Medicaid Emergency Psychiatric Demonstration (MEPD) Evaluation; Use: Since the VerDate Mar<15>2010 18:54 Jul 25, 2013 Jkt 229001 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 (OCN: 0938– NEW); Frequency: Annually; Affected Public: Individuals and households; State, Local and Tribal governments; Business and other for-profits and Notfor-profits; Number of Respondents: 93; Total Annual Responses: 1,944; Total Annual Hours: 2,046. (For policy questions regarding this collection contact Negussie Tilahun at 410–786– 2058.) 3. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Medicare Current Beneficiary Survey; Use: We are the largest single payer of health care in the United States. With full implementation of the Affordable Care Act of 2010 (ACA), the agency will play a direct or indirect role in administering health insurance coverage for more than 120 million people across the Medicare, Medicaid, CHIP, and Exchange populations. One of our critical aims is to be an effective steward, major force, and trustworthy partner in leading the transformation of the health care system. We also aim to provide Americans with high quality care and better health at lower costs through improvement. At the forefront of these initiatives is the newly formed Center PO 00000 Frm 00038 Fmt 4703 Sfmt 4703 for Medicare and Medicaid Innovation (CMMI). CMMI is authorized by Section 1115A of the Social Security Act, as established by section 3021 of the ACA and was established to ‘‘test innovative payment and service delivery models to reduce program expenditures. . .while preserving or enhancing the quality of care furnished’’ to Medicare, Medicaid and CHIP beneficiaries. Implicit across all of CMMI activities is an emphasis on diffusion—finding and validating innovative models that have the potential to scale, facilitating rapid adoption, and letting them take root in organizations, health systems, and communities across America. The Medicare Current Beneficiary Survey (MCBS) is the most comprehensive and complete survey available on the Medicare population and is essential in capturing data not otherwise collected through our operations. The MCBS is an in-person, nationally-representative, longitudinal survey of Medicare beneficiaries that we sponsor and is directed by the Office of Information Products and Data Analytics (OIPDA) in partnership with the CMMI. The survey captures beneficiary information whether aged or disabled, living in the community or facility, or serviced by managed care or fee-for-service. Data produced as part of the MCBS are enhanced with our administrative data (e.g. fee-for-service claims, prescription drug event data, enrollment, etc.) to provide users with more accurate and complete estimates of total health care costs and utilization. The MCBS has been continuously fielded for more than 20 years (encompassing over 1 million interviews), and consists of three annual interviews per survey participant. The MCBS continues to provide unique insight into the Medicare program and helps both us and our external stakeholders better understand and evaluate the impact of existing programs and significant new policy initiatives. In the past, MCBS data have been used to assess potential changes to the Medicare program. For example, the MCBS was instrumental in supporting the development and implementation of the Medicare prescription drug benefit by providing a means to evaluate prescription drug costs and out-ofpocket burden for these drugs to Medicare beneficiaries. Form Number: CMS–P–0015A (OCN: 0938–0568); Frequency: Occasionally; Affected Public: Business or other for-profits and Not-for-profit institutions; Number of Respondents: 16,550; Total Annual Responses: 49,650; Total Annual Hours: 58,450 (For policy questions regarding E:\FR\FM\26JYN1.SGM 26JYN1 tkelley on DSK3SPTVN1PROD with NOTICES Federal Register / Vol. 78, No. 144 / Friday, July 26, 2013 / Notices this collection contact William Long at 410–786–7927.) 4. Type of Information Collection Request: Reinstatement with change of a previously approved collection; Title of Information Collection: Advance Directives (Medicare and Medicaid) and Supporting Regulations; Use: The advance directives requirement was enacted because Congress wanted individuals to know that they have a right to make health care decisions and to refuse treatment even when they are unable to communicate. Steps have been taken at both the federal and state level, to afford greater opportunity for the individual to participate in decisions made concerning the medical treatment to be received by an adult patient in the event that the patient is unable to communicate to others, a preference about medical treatment. The individual may make his preference known through the use of an advance directive, which is a written instruction prepared in advance, such as a living will or durable power of attorney. This information is documented in a prominent part of the individual’s medical record. Advance directives as described in the Patient SelfDetermination Act have increased the individual’s control over decisions concerning medical treatment. Sections 4206 of the Omnibus Budget Reconciliation Act of 1990 defined an advance directive as a written instruction recognized under State law relating to the provision of health care when an individual is incapacitated (those persons unable to communicate their wishes regarding medical treatment). All states have enacted legislation defining a patient’s right to make decisions regarding medical care, including the right to accept or refuse medical or surgical treatment and the right to formulate advance directives. Participating hospitals, skilled nursing facilities, nursing facilities, home health agencies, providers of home health care, hospices, religious nonmedical health care institutions, and prepaid or eligible organizations (including Health Care Prepayment Plans (HCPPs) and Medicare Advantage Organizations (MAOs) such as Coordinated Care Plans, Demonstration Projects, Chronic Care Demonstration Projects, Program of All Inclusive Care for the Elderly, Private Fee for Service, and Medical Savings Accounts must provide written information, at explicit time frames, to all adult individuals about: a) the right to accept or refuse medical or surgical treatments; b) the right to formulate an advance directive; c) a description of applicable State law (provided by the VerDate Mar<15>2010 18:54 Jul 25, 2013 Jkt 229001 State); and d) the provider’s or organization’s policies and procedures for implementing an advance directive. Form Number: CMS–R–10 (OCN: 0938– 0610); Frequency: Yearly; Affected Public: Business or other for-profits; Number of Respondents: 39,575; Total Annual Responses: 39, 575; Total Annual Hours: 2,836,441. (For policy questions regarding this collection contact Sonia Swancy at 410–786– 8445.) 5. Type of Information Collection Request: Extension of a currently approved collection. Title of Information Collection: Prospective Payments for Hospital Outpatient Services and Supporting Regulations; Use: The Secretary is required to establish a prospective payment system (PPS) for hospital outpatient services. Successful implementation of an outpatient PPS (OPPS) requires that we distinguish facilities or organizations that function as departments of hospitals from those that are freestanding. In this regard, we will be able to determine: which services should be paid under the OPPS, the clinical laboratory fee schedule, or other payment provisions applicable to services furnished to hospital outpatients. Information from 42 CFR 413.65(b)(3) and (c) reports is needed to make these determinations. Additionally, hospitals and other providers are authorized to impose deductible and coinsurance charges for facility services, but does not allow such charges by facilities or organizations which are not provider-based. This provision requires that we collect information from the required reports so it can determine which facilities are provider-based. Form Number: CMS–R– 240 (OCN: 0938–0798). Frequency: Occasionally; Affected Public: Private sector—Business or other for-profits and Not-for-profit institutions; Number of Respondents: 905; Total Annual Responses: 500,405; Total Annual Hours: 26,563. (For policy questions regarding this collection contact Daniel Schroder at 410–786–7452.) 6. Type of Information Collection Request: Reinstatement with change of a previously approved collection; Title of Information Collection: Conditions of Participation for Comprehensive Outpatient Rehabilitation Facilities (CORFs) and Supporting Regulations; Use: The Conditions of Participation (CoPs) and accompanying requirements specified in the regulations are used by our surveyors as a basis for determining whether a comprehensive outpatient rehabilitation facility (CORF) qualifies to be awarded a Medicare provider agreement. We believe the health care PO 00000 Frm 00039 Fmt 4703 Sfmt 4703 45207 industry practice demonstrates that the patient clinical records and general content of records are necessary to ensure the well-being and safety of patients and that professional treatment and accountability are a normal part of industry practice. Form Number: CMS– 10282 (OCN: 0938–1091); Frequency: Yearly; Affected Public: Private sector— Business or other for-profit and Not-forprofit institutions; Number of Respondents: 314; Total Annual Responses: 314; Total Annual Hours: 8,076. (For policy questions regarding this collection contact Jacqueline Leach at 410–786–4282.) 7. Type of Information Collection Request: Reinstatement with change of a previously approved collection; Title of Information Collection: Final Peer Review Organizations Sanction Regulations in 42 CFR Sections 1004.40, 1004.50, 1004.60, and 1004.70; Use: The Peer Review Improvement Act of 1982 amended Title XI of the Social Security Act (the Act), creating the Utilization and Quality Control Peer Review Organization Program. Section 1156 of the Act imposes obligations on health care practitioners and others who furnish or order services or items under Medicare. This section also provides for sanction actions, if the Secretary determines that the obligations as stated by this section are not met. Quality Improvement Organizations (QIOs) are responsible for identifying violations. The QIOs may allow practitioners or other entities, opportunities to submit relevant information before determining that a violation has occurred. The information collection requirements contained in this information collection request are used by the QIOs to collect the information necessary to make their decision. Form Number: CMS–R–65 (OCN: 0938–0444); Frequency: On occasion; Affected Public: Private sector—Business or other for-profit and Not-for-profit institutions; Number of Respondents: 53; Total Annual Responses: 53; Total Annual Hours: 14,310. (For policy questions regarding this collection contact Coles Mercier at 410–786–2112.) 8. Type of Information Collection Request: New collection (Request for a new OMBcontrol number); Title of Information Collection: Enrollment Assistance Program; Use: As required by the Affordable Care Act, CMS will implement a grant-based Navigator Program to provide support to targeted communities. However, there will also be a need for broader based enrollment assistance in population centers that we identify in states with Federallyfacilitated Marketplaces (FFMs) to provide Health Insurance Marketplace E:\FR\FM\26JYN1.SGM 26JYN1 45208 Federal Register / Vol. 78, No. 144 / Friday, July 26, 2013 / Notices enrollment assistance to populations not covered or targeted by the Navigator Program. The target populations are individual consumers and families eligible to enroll in Qualified Health Plans (QHPs) in population centers we identify. Without such access to inperson enrollment assistance, millions of individuals who will be eligible for health insurance coverage in the Marketplaces might not have access to the direct assistance required to make educated choices on available healthcare options and may therefore be unable to successfully enroll in the Marketplaces. To monitor program effectiveness, the Enrollment Assistance Program will provide weekly, monthly, quarterly and annual reports to us. Form Number: CMS–10491 (OCN: 0938– NEW); Frequency: Weekly, Monthly, Quarterly, Yearly; Affected Public: Private Sector; Number of Respondents: 1; Number of Responses: 84; Total Annual Hours: 554. (For policy questions regarding this collection contact Eliza Bangit at 301–492–4219.) Dated: July 23, 2013. Martique Jones, Deputy Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2013–17985 Filed 7–25–13; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS–2388–N] RIN 0938–AR79 Children’s Health Insurance Program (CHIP); Final Allotments to States, the District of Columbia, and U.S. Territories and Commonwealths for Fiscal Year 2013 Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. AGENCY: This notice sets forth the final allotments of federal funding available to each State, the District of Columbia, and each U.S. Territory and Commonwealth for fiscal year 2013. Title XXI of the Social Security Act (the Act) authorizes payment of federal matching funds to States, the District of Columbia, and the U.S. Territories and Commonwealths to initiate and expand health insurance coverage to uninsured, low-income children under the Children’s Health Insurance Program (CHIP). The fiscal year allotments tkelley on DSK3SPTVN1PROD with NOTICES SUMMARY: VerDate Mar<15>2010 18:54 Jul 25, 2013 Jkt 229001 contained in this notice were determined in accordance with the funding provisions and final regulations published in the February 17, 2011 Federal Register (76 FR 9233). DATES: This notice is effective on August 26, 2013. Final allotments for fiscal year 2013 may be available for expenditure by states beginning with October 1, 2012. FOR FURTHER INFORMATION CONTACT: Richard Strauss, (410) 786–2019. SUPPLEMENTARY INFORMATION: I. Purpose of This Notice This notice sets forth the allotments available to each state, the District of Columbia, and each U.S. Territory and Commonwealth for fiscal year (FY) 2013 under title XXI of the Social Security Act (the Act). States may implement the Children’s Health Insurance Program (CHIP) through a separate state program under title XXI of the Act, an expansion of a State Medicaid program under title XIX of the Act, or a combination of both. CHIP allotments for FY 2009 and subsequent fiscal years are available to match expenditures under an approved state child health plan for 2 fiscal years, including the year for which the allotments were provided. As specified by the Act, the allotments are available to states for FY 2013, and the unexpended amounts of such allotments for a state may be carried over to FY 2014 for use by the state. Federal funds appropriated for title XXI of the Act are limited, and the law specifies a methodology to divide the total fiscal year appropriation into individual allotments available for each state, the District of Columbia, and each U.S. Territory and Commonwealth with an approved child health plan. Section 2104(b) of the Act requires states, the District of Columbia, and U.S. Territories and Commonwealths to have an approved child health plan for the fiscal year in order for the Secretary to provide an allotment for that fiscal year. All states, the District of Columbia, and U.S. Territories and Commonwealths have approved plans for FY 2013. Therefore, the FY 2013 allotments contained in this notice pertain to all states, the District of Columbia, and U.S. Territories and Commonwealths. In general, funding is appropriated under section 2104(a) of the Act for purposes of providing allotments to states under CHIP for each fiscal year. Section 2104(a) was amended by section 10203(d)(1) of the Patient Protection and Affordable Care Act of 2010 (Pub. L. 111–148, enacted on March 23, 2010) (the Affordable Care Act) to extend PO 00000 Frm 00040 Fmt 4703 Sfmt 4703 appropriations for funding for CHIP fiscal year allotments through FY 2015. II. Methodology for Determining CHIP Fiscal Year Allotments for the 50 States, the District of Columbia, and the U.S. Territories and Commonwealths A. Funding Authority for the CHIP Fiscal Year Allotments Section 2104(a)(1) through (18) of the Act appropriates federal funds for providing states’ allotments for FYs 2009 through 2015. In particular, the appropriated amounts available for allotments for FYs 2009 through 2015, are as follows: $10,562,000,000 for FY 2009; 12,520,000,000 for FY 2010; $13,459,000,000 for FY 2011; $14,982,000,000 for FY 2012; $17,406,000,000 for FY 2013, $19,147,000,000 for FY 2014; and $2,850,000,000 for each of the first and second half of FY 2015. Also, section 108 of the Children’s Health Insurance Program Reauthorization Act of 2009 (Pub. L. 111–3, enacted on February 4, 2009) (CHIPRA), as amended by section 10203(d) of the Affordable Care Act, provides for a one-time appropriation of $15,361,000,000 for allotments for the first half of FY 2015. Therefore, the total appropriation for providing allotments during FY 2015 is $21,061,000,000 (determined as the sum of $2,850,000,000, $15,361,000,000, and $2,850,000,000). B. Methodology for Determining State’s Fiscal Year Allotments 1. General On September 16, 2009 we published a proposed rule in the Federal Register (74 FR 47517) and on February 17, 2011, we published the final rule in the Federal Register (76 FR 9233) to implement the methodologies and procedures to determine the fiscal year allotments of federal funds as specified under section 2104(m) of the Act for FY 2009 through FY 2015. In general, the States’ fiscal year allotments are provided from the appropriation for the respective fiscal year allotment, subject to a proration adjustment described in section II.B.7 of this notice. 2. FY 2009 Through FY 2012 CHIP Allotments The final methodology is determined in accordance with the September 16, 2009 Federal Register (74 FR 47517) which contained the FY 2009 CHIP allotments, the February 17, 2011 Federal Register (76 FR 9233) which contained the FY 2010 and FY 2011 CHIP allotments, and the July 24, 2012 Federal Register (77 FR 43290) which contained the FY 2012 CHIP allotments. E:\FR\FM\26JYN1.SGM 26JYN1

Agencies

[Federal Register Volume 78, Number 144 (Friday, July 26, 2013)]
[Notices]
[Pages 45205-45208]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-17985]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-10326, CMS-10487, CMS-P-0015A, CMS-R-10, 
CMS-R-240, CMS-10282, CMS-R-65 and CMS-10491]


Agency Information Collection Activities: Proposed Collection; 
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 (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 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.

DATES: Comments must be received by September 24, 2013:

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number (OCN). 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 --------, 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.

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-10326 Electronic Submission of Medicare Graduate Medical 
Education (GME) Affiliation Agreements
CMS-10487 Medicaid Emergency Psychiatric Demonstration (MEPD) 
Evaluation
CMS-P-0015A Medicare Current Beneficiary Survey
CMS-R-10 Advance Directives (Medicare and Medicaid) and Supporting 
Regulations

[[Page 45206]]

CMS-R-240 Prospective Payments for Hospital Outpatient Services and 
Supporting Regulations
CMS-10282 Conditions of Participation for Comprehensive Outpatient 
Rehabilitation Facilities (CORFs) and supporting regulations
CMS-R-65 Final Peer Review Organizations Sanction Regulations in 42 
CFR Sections 1004.40, 1004.50, 1004.60, and 1004.70
CMS-10491 Enrollment Assistance Program
    Under the Paperwork Reduction Act (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 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 Collections
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Electronic 
Submission of Medicare Graduate Medical Education (GME) Affiliation 
Agreements; Use: We use the information contained in electronic 
affiliation agreements as documentation of the existence of Medicare 
GME affiliations, and to verify that the affiliations being formed by 
teaching hospitals for the purposes of sharing their Medicare Graduate 
Medical Education FTE cap slots are valid according to CMS regulations. 
The affiliation agreements are also used as reference materials when 
potential issues involving specific affiliations arise. Form Number: 
CMS-10326 (OCN: 0938-1111); Frequency: Yearly; Affected Public: Private 
sector--Business or other for-profits and Not-for-profit institutions; 
Number of Respondents: 125; Total Annual Responses: 125; Total Annual 
Hours: 166. (For policy questions regarding this collection contact 
Tzvi Hefter at 410-786-0614.)
    2. Type of Information Collection Request: New Collection (Request 
for a new OMBcontrol number); 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 (OCN: 
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 Negussie Tilahun at 410-
786-2058.)
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare Current 
Beneficiary Survey; Use: We are the largest single payer of health care 
in the United States. With full implementation of the Affordable Care 
Act of 2010 (ACA), the agency will play a direct or indirect role in 
administering health insurance coverage for more than 120 million 
people across the Medicare, Medicaid, CHIP, and Exchange populations. 
One of our critical aims is to be an effective steward, major force, 
and trustworthy partner in leading the transformation of the health 
care system. We also aim to provide Americans with high quality care 
and better health at lower costs through improvement. At the forefront 
of these initiatives is the newly formed Center for Medicare and 
Medicaid Innovation (CMMI).
    CMMI is authorized by Section 1115A of the Social Security Act, as 
established by section 3021 of the ACA and was established to ``test 
innovative payment and service delivery models to reduce program 
expenditures. . .while preserving or enhancing the quality of care 
furnished'' to Medicare, Medicaid and CHIP beneficiaries. Implicit 
across all of CMMI activities is an emphasis on diffusion--finding and 
validating innovative models that have the potential to scale, 
facilitating rapid adoption, and letting them take root in 
organizations, health systems, and communities across America.
    The Medicare Current Beneficiary Survey (MCBS) is the most 
comprehensive and complete survey available on the Medicare population 
and is essential in capturing data not otherwise collected through our 
operations. The MCBS is an in-person, nationally-representative, 
longitudinal survey of Medicare beneficiaries that we sponsor and is 
directed by the Office of Information Products and Data Analytics 
(OIPDA) in partnership with the CMMI. The survey captures beneficiary 
information whether aged or disabled, living in the community or 
facility, or serviced by managed care or fee-for-service. Data produced 
as part of the MCBS are enhanced with our administrative data (e.g. 
fee-for-service claims, prescription drug event data, enrollment, etc.) 
to provide users with more accurate and complete estimates of total 
health care costs and utilization. The MCBS has been continuously 
fielded for more than 20 years (encompassing over 1 million 
interviews), and consists of three annual interviews per survey 
participant.
    The MCBS continues to provide unique insight into the Medicare 
program and helps both us and our external stakeholders better 
understand and evaluate the impact of existing programs and significant 
new policy initiatives. In the past, MCBS data have been used to assess 
potential changes to the Medicare program. For example, the MCBS was 
instrumental in supporting the development and implementation of the 
Medicare prescription drug benefit by providing a means to evaluate 
prescription drug costs and out-of-pocket burden for these drugs to 
Medicare beneficiaries. Form Number: CMS-P-0015A (OCN: 0938-0568); 
Frequency: Occasionally; Affected Public: Business or other for-profits 
and Not-for-profit institutions; Number of Respondents: 16,550; Total 
Annual Responses: 49,650; Total Annual Hours: 58,450 (For policy 
questions regarding

[[Page 45207]]

this collection contact William Long at 410-786-7927.)
    4. Type of Information Collection Request: Reinstatement with 
change of a previously approved collection; Title of Information 
Collection: Advance Directives (Medicare and Medicaid) and Supporting 
Regulations; Use: The advance directives requirement was enacted 
because Congress wanted individuals to know that they have a right to 
make health care decisions and to refuse treatment even when they are 
unable to communicate. Steps have been taken at both the federal and 
state level, to afford greater opportunity for the individual to 
participate in decisions made concerning the medical treatment to be 
received by an adult patient in the event that the patient is unable to 
communicate to others, a preference about medical treatment. The 
individual may make his preference known through the use of an advance 
directive, which is a written instruction prepared in advance, such as 
a living will or durable power of attorney. This information is 
documented in a prominent part of the individual's medical record. 
Advance directives as described in the Patient Self-Determination Act 
have increased the individual's control over decisions concerning 
medical treatment. Sections 4206 of the Omnibus Budget Reconciliation 
Act of 1990 defined an advance directive as a written instruction 
recognized under State law relating to the provision of health care 
when an individual is incapacitated (those persons unable to 
communicate their wishes regarding medical treatment).
    All states have enacted legislation defining a patient's right to 
make decisions regarding medical care, including the right to accept or 
refuse medical or surgical treatment and the right to formulate advance 
directives. Participating hospitals, skilled nursing facilities, 
nursing facilities, home health agencies, providers of home health 
care, hospices, religious nonmedical health care institutions, and 
prepaid or eligible organizations (including Health Care Prepayment 
Plans (HCPPs) and Medicare Advantage Organizations (MAOs) such as 
Coordinated Care Plans, Demonstration Projects, Chronic Care 
Demonstration Projects, Program of All Inclusive Care for the Elderly, 
Private Fee for Service, and Medical Savings Accounts must provide 
written information, at explicit time frames, to all adult individuals 
about: a) the right to accept or refuse medical or surgical treatments; 
b) the right to formulate an advance directive; c) a description of 
applicable State law (provided by the State); and d) the provider's or 
organization's policies and procedures for implementing an advance 
directive. Form Number: CMS-R-10 (OCN: 0938-0610); Frequency: Yearly; 
Affected Public: Business or other for-profits; Number of Respondents: 
39,575; Total Annual Responses: 39, 575; Total Annual Hours: 2,836,441. 
(For policy questions regarding this collection contact Sonia Swancy at 
410-786-8445.)
    5. Type of Information Collection Request: Extension of a currently 
approved collection.
    Title of Information Collection: Prospective Payments for Hospital 
Outpatient Services and Supporting Regulations; Use: The Secretary is 
required to establish a prospective payment system (PPS) for hospital 
outpatient services. Successful implementation of an outpatient PPS 
(OPPS) requires that we distinguish facilities or organizations that 
function as departments of hospitals from those that are freestanding. 
In this regard, we will be able to determine: which services should be 
paid under the OPPS, the clinical laboratory fee schedule, or other 
payment provisions applicable to services furnished to hospital 
outpatients. Information from 42 CFR 413.65(b)(3) and (c) reports is 
needed to make these determinations. Additionally, hospitals and other 
providers are authorized to impose deductible and coinsurance charges 
for facility services, but does not allow such charges by facilities or 
organizations which are not provider-based. This provision requires 
that we collect information from the required reports so it can 
determine which facilities are provider-based. Form Number: CMS-R-240 
(OCN: 0938-0798). Frequency: Occasionally; Affected Public: Private 
sector--Business or other for-profits and Not-for-profit institutions; 
Number of Respondents: 905; Total Annual Responses: 500,405; Total 
Annual Hours: 26,563. (For policy questions regarding this collection 
contact Daniel Schroder at 410-786-7452.)
    6. Type of Information Collection Request: Reinstatement with 
change of a previously approved collection; Title of Information 
Collection: Conditions of Participation for Comprehensive Outpatient 
Rehabilitation Facilities (CORFs) and Supporting Regulations; Use: The 
Conditions of Participation (CoPs) and accompanying requirements 
specified in the regulations are used by our surveyors as a basis for 
determining whether a comprehensive outpatient rehabilitation facility 
(CORF) qualifies to be awarded a Medicare provider agreement. We 
believe the health care industry practice demonstrates that the patient 
clinical records and general content of records are necessary to ensure 
the well-being and safety of patients and that professional treatment 
and accountability are a normal part of industry practice. Form Number: 
CMS-10282 (OCN: 0938-1091); Frequency: Yearly; Affected Public: Private 
sector--Business or other for-profit and Not-for-profit institutions; 
Number of Respondents: 314; Total Annual Responses: 314; Total Annual 
Hours: 8,076. (For policy questions regarding this collection contact 
Jacqueline Leach at 410-786-4282.)
    7. Type of Information Collection Request: Reinstatement with 
change of a previously approved collection; Title of Information 
Collection: Final Peer Review Organizations Sanction Regulations in 42 
CFR Sections 1004.40, 1004.50, 1004.60, and 1004.70; Use: The Peer 
Review Improvement Act of 1982 amended Title XI of the Social Security 
Act (the Act), creating the Utilization and Quality Control Peer Review 
Organization Program. Section 1156 of the Act imposes obligations on 
health care practitioners and others who furnish or order services or 
items under Medicare. This section also provides for sanction actions, 
if the Secretary determines that the obligations as stated by this 
section are not met. Quality Improvement Organizations (QIOs) are 
responsible for identifying violations. The QIOs may allow 
practitioners or other entities, opportunities to submit relevant 
information before determining that a violation has occurred. The 
information collection requirements contained in this information 
collection request are used by the QIOs to collect the information 
necessary to make their decision. Form Number: CMS-R-65 (OCN: 0938-
0444); Frequency: On occasion; Affected Public: Private sector--
Business or other for-profit and Not-for-profit institutions; Number of 
Respondents: 53; Total Annual Responses: 53; Total Annual Hours: 
14,310. (For policy questions regarding this collection contact Coles 
Mercier at 410-786-2112.)
    8. Type of Information Collection Request: New collection (Request 
for a new OMBcontrol number); Title of Information Collection: 
Enrollment Assistance Program; Use: As required by the Affordable Care 
Act, CMS will implement a grant-based Navigator Program to provide 
support to targeted communities. However, there will also be a need for 
broader based enrollment assistance in population centers that we 
identify in states with Federally-facilitated Marketplaces (FFMs) to 
provide Health Insurance Marketplace

[[Page 45208]]

enrollment assistance to populations not covered or targeted by the 
Navigator Program. The target populations are individual consumers and 
families eligible to enroll in Qualified Health Plans (QHPs) in 
population centers we identify. Without such access to in-person 
enrollment assistance, millions of individuals who will be eligible for 
health insurance coverage in the Marketplaces might not have access to 
the direct assistance required to make educated choices on available 
healthcare options and may therefore be unable to successfully enroll 
in the Marketplaces. To monitor program effectiveness, the Enrollment 
Assistance Program will provide weekly, monthly, quarterly and annual 
reports to us. Form Number: CMS-10491 (OCN: 0938-NEW); Frequency: 
Weekly, Monthly, Quarterly, Yearly; Affected Public: Private Sector; 
Number of Respondents: 1; Number of Responses: 84; Total Annual Hours: 
554. (For policy questions regarding this collection contact Eliza 
Bangit at 301-492-4219.)

    Dated: July 23, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2013-17985 Filed 7-25-13; 8:45 am]
BILLING CODE 4120-01-P
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