Agency Information Collection Activities: Proposed Collection; Comment Request, 5118-5120 [2015-01790]
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5118
Federal Register / Vol. 80, No. 20 / Friday, January 30, 2015 / Notices
Prevention and the Agency for Toxic
Substances and Disease Registry.
Elaine L. Baker,
Director, Management Analysis and Services
Office, Centers for Disease Control and
Prevention.
[FR Doc. 2015–01768 Filed 1–29–15; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier CMS–R–306, CMS–
10371, CMS–10392, CMS–10418, CMS–
10472, CMS–10494 and CMS–10549]
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
automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
SUMMARY:
Comments must be received by
March 31, 2015.
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
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DATES:
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Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) that are accepting
comments.
2. By regular mail. You may mail
written comments to the following
address: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: Document Identifier/OMB
Control Number lll, Room C4–26–
05, 7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
To obtain copies of a supporting
statement and any related forms for the
proposed collection(s) summarized in
this notice, you may make your request
using one of following:
1. Access CMS’ Web site address at
https://www.cms.hhs.gov/
PaperworkReductionActof1995.
2. Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
Reports Clearance Office at (410) 786–
1326.
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–R–306 Use of Restraint and
Seclusion in Psychiatric Residential
Treatment Facilities (PRTFs) for
Individuals Under Age 21 and
Supporting Regulations
CMS–10371 Cooperative Agreements
to Support Establishment of StateOperated Health Insurance Exchanges
CMS–10392 Consumer Operated and
Oriented (CO–OP) Program
CMS–10418 Annual MLR and Rebate
Calculation Report and MLR Rebate
Notices
CMS–10472 Exchange Functions:
Standards for Navigators and NonNavigator Assistance
CMS–10494 Standards for Navigators
and Non-Navigator Assistance
Personnel; Consumer Assistance
Tools and Programs of an Exchange
and Certified Application Counselors
CMS–10549 Generic Clearance for
Questionnaire Testing and
Methodological Research for the
Medicare Current Beneficiary Survey
(MCBS)
Under the PRA (44 U.S.C. 3501–
3520), federal agencies must obtain
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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 Collection
1. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Use of Restraint
and Seclusion in Psychiatric Residential
Treatment Facilities (PRTFs) for
Individuals Under Age 21 and
Supporting Regulations; Use:
Psychiatric residential treatment
facilities are required to report deaths,
serious injuries and attempted suicides
to the State Medicaid Agency and the
Protection and Advocacy Organization.
They are also required to provide
residents the restraint and seclusion
policy in writing, and to document in
the residents’ records all activities
involving the use of restraint and
seclusion. Form Number: CMS–R–306
(OMB Control Number 0938–0833);
Frequency: Occasionally; Affected
Public: Private sector (Business or other
for-profits); Number of Respondents:
390; Total Annual Responses:
1,466,795; Total Annual Hours: 431,062.
(For policy questions regarding this
collection contact Cindy Ruff at 410–
786–5916).
2. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Cooperative
Agreements to Support Establishment of
State-Operated Health Insurance
Exchanges; Use: All States (including
the 50 States, consortia of States, and
the District of Columbia herein referred
to as States) had the opportunity under
Section 1311(b) of the Affordable Care
to apply for three types of grants: (1)
Planning grants; (2) Early Innovator
grants for early development of
information technology; and (3)
Establishment grants to develop,
implement and start-up Marketplaces.
As of January 1st, 2015, the Secretary
has disbursed over $5.4 billion under
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this grant program and, as of that date,
there were 79 active establishment
grants awarded to 28 states. As the
State-Based Marketplaces (SBM) and
Small Business Health Options Program
(SHOP) have matured and moved from
the developmental phases to fulloperation, the reporting requirements
for the states have been modified and
streamlined to insure only information
necessary to provide effective oversight
of their operations by CMS is collected.
Given the innovative nature of
Exchanges and the statutorilyprescribed relationship between the
Secretary and States in their
development and operation, it is critical
that the Secretary work closely with
States to provide necessary guidance
and technical assistance to ensure that
States can meet the prescribed
timelines, federal requirements, and
goals of the statute and the grants
awarded to them. Form Number: CMS–
10371 (OMB Control Number: 0938–
1119); Frequency: Once; Affected
Public: State Government agencies, nonprofit entities; Number of Respondents:
28; Number of Responses: 48; Total
Annual Hours: 31,404. (For policy
questions regarding this collection
contact Dena Pushkin at 301–492–4342.)
3. Type of Information Collection
Request: Revision of a currently
approved information collection; Title
of Information Collection: Consumer
Operated and Oriented (CO–OP)
Program; Use: The Consumer Operated
and Oriented Plan (CO–OP) program
was established by Section 1322 of the
Affordable Care Act. This program
provides for loans to establish at least
one consumer-operated, qualified
nonprofit health insurance issuer in
each State. Issuers supported by the
CO–OP program will offer at least one
qualified health plan at the silver level
of benefits and one at the gold level of
benefits in the individual market State
Health Benefit Exchanges (Exchanges).
At least two-thirds of policies or
contracts offered by a CO–OP will be
open to individuals and small
employers. Profits generated by the
nonprofit CO–OPs will be used to lower
premiums, improve benefits, improve
the quality of health care delivered to
their members, expand enrollment, or
otherwise contribute to the stability of
coverage offered by the CO–OP. By
increasing competition in the health
insurance market and operating with a
strong consumer focus, the CO–OP
program will provide consumers more
choices, greater plan accountability,
increased competition to lower prices,
and better models of care, benefiting all
consumers, not just CO–OP members.
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The CO–OP program will provide
nonprofits with loans to fund start-up
costs and State reserve requirements, in
the form of Start-up Loans and Solvency
Loans. An applicant may apply for (1)
joint Start-up and Solvency Loans; or (3)
only a Solvency Loan. Planning Loans
are intended to help loan recipients
determine the feasibility of operating a
CO–OP in a target market. Start-up
Loans are intended to assist loan
recipients with the many start-up costs
associated with establishing a new
health insurance issuer. Solvency Loans
are intended to assist loan recipients
with meeting the solvency requirements
of States in which the applicant seeks to
be licensed to issue qualified health
plans. Form Number: CMS–10392 (OMB
control number: 0938–1139); Frequency:
Occasionally; Affected Public: Private
sector (Not-for-profit institutions);
Number of Respondents: 23; Total
Annual Responses: 675; Total Annual
Hours: 93,220. (For policy questions
regarding this collection contact Deepti
Loharikar 301–492–4126).
4. Type of Information Collection
Request: Revision of a currently
approved information collection; Title
of Information Collection: Annual MLR
and Rebate Calculation Report and MLR
Rebate Notices; Use: Under Section
2718 of the Affordable Care Act and
implementing regulation at 45 CFR part
158, a health insurance issuer (issuer)
offering group or individual health
insurance coverage must submit a report
to the Secretary concerning the amount
the issuer spends each year on claims,
quality improvement expenses, nonclaims costs, Federal and State taxes
and licensing and regulatory fees, the
amount of earned premium, and
beginning with the 2014 reporting year,
the amounts related to the transitional
reinsurance, risk adjustment, and risk
corridors. An issuer must provide an
annual rebate if the amount it spends on
certain costs compared to its premium
revenue (excluding Federal and States
taxes and licensing and regulatory fees)
does not meet a certain ratio, referred to
as the medical loss ratio (MLR). An
interim final rule (IFR) implementing
the MLR was published on December 1,
2010 (75 FR 74865) and modified by
technical corrections on December 30,
2010 (75 FR 82277), which added Part
158 to Title 45 of the Code of Federal
Regulations. The IFR is effective January
1, 2011. A final rule regarding selected
provisions of the IFR was published on
December 7, 2011 (76 FR 76574, CMS–
9998–FC) and an interim final rule
regarding an issue not included in
issuers’ reporting obligations
(disbursement of rebates by non-federal
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5119
governmental plans) was also published
December 7, 2011 (76 FR 76596, CMS–
9998–IFC2). Both rules published on
December 7, 2011 are effective January
1, 2012. Each issuer is required to
submit annually MLR data, including
information about any rebates it must
provide, on a form prescribed by CMS,
for each State in which the issuer
conducts business. Each issuer is also
required to provide a rebate notice to
each policyholder that is owed a rebate
and each subscriber of policyholders
that are owed a rebate for any given
MLR reporting year. Additionally, each
issuer is required to maintain for a
period of seven years all documents,
records and other evidence that support
the data included in each issuer’s
annual report to the Secretary. Under
Section 1342 of the Patient Protection
and Affordable Care Act and
implementing regulation at 45 CFR part
153, issuers of qualified health plans
(QHPs) must participate in a risk
corridors program. A QHP issuer is
required to pay charges to or receive
payments from CMS based on the ratio
of the issuer’s allowable costs to the
target amount. A final rule (Premium
Stabilization Rule) implementing the
risk corridors program was published on
March 23, 2012 (77 FR 17220), which
added Part 153 to Title 45 of the Code
of Federal Regulations. The Premium
Stabilization Rule is effective May 22,
2012. Final rules (2014 and 2015
Payment Notices) outlining the risk
corridors benefit and payment
parameters for the 2014 and 2015
benefit years were published on March
11, 2013 (78 FR 15410) and March 11,
2014 (79 FR 13744), respectively. The
2014 and 2015 Payment Notices are
effective April 30, 2013 and May 12,
2014, respectively. Each QHP issuer is
required to submit an annual report to
CMS concerning the issuer’s allowable
costs, allowable administrative costs,
and the amount of premium.
Based upon our experience in the
MLR data collection and evaluation
process, we are updating its annual
burden hour estimates to reflect the
actual numbers of submissions, rebates
and rebate notices. In addition, we are
updating its annual burden hour
estimates to reflect the additional
burden (published in the 2015 Payment
Notice) related to the risk corridors data
submission requirements.
The 2014 MLR Reporting Form and
instructions reflect changes for the 2014
reporting year and beyond that are set
forth in the March 2013 update to 45
CFR part 158 regarding the MLR
reporting and rebate distribution
deadlines and the accounting for the
transitional reinsurance, risk
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adjustment, and risk corridors. The 2014
MLR Reporting Form and instructions
are also modified to include the
reporting elements required under the
risk corridors data submission
requirements in 45 CFR 153.530. In
2015, it is expected that issuers will
send fewer notices and rebate checks to
policyholders and subscribers, which
will reduce burden on issuers. On the
other hand, the requirement to report
the risk corridors data will increase
burden for QHP issuers. It is estimated
that there will be a net reduction in total
burden from 294,911 to 271,600. Form
Number: CMS–10418 (OMB control
number: 0938–1164); Frequency:
Annually; Affected Public: Private
Sector, Business or other for-profits and
not-for-profit institutions; Number of
Respondents: 517; Number of
Responses: 3,307; Total Annual Hours:
271,600. (For policy questions regarding
this collection, contact Julie McCune at
(301) 492–4196.)
5. Type of Information Collection
Request: Revision of a previously
approved information collection; Title
of Information Collection: Patient
Protection and Affordable Care Act;
Consumer Assistance Tools and
Programs of an Exchange and Certified
Application Counselors; Exchange and
Insurance Market Standards for 2015;
Use: Section 1321(a)(1) of the Affordable
Care Act directs and authorizes the
Secretary to issue regulations setting
standards for meeting the requirements
under title I of the Affordable Care Act,
with respect to, among other things, the
establishment and operation of
Exchanges. Pursuant to this authority,
regulations have been finalized at 45
CFR 155.215(b)(1) to require Navigators,
as well as those non-Navigator
personnel to whom 45 CFR 155.215
applies, requires completion of HHS
approved training for initial certification
and annual recertification prior to
providing application and enrollment
assistance. The training will include an
optional training quality questionnaire
providing Navigators and non-Navigator
assistance personnel to whom 45 CFR
155.215 applies, an opportunity to
provide feedback to CMS regarding the
training and any improvements that can
be made in the future. Form Number:
CMS–10472 (OMB Control Number:
0938–1220); Frequency: On Occasion;
Affected Public: State, Local, or Tribal
Governments, Private Sector (not-forprofit institutions); individuals or
households; Number of Respondents:
5,610; Number of Responses: 5,610;
Total Annual Hours: 37,036. (For policy
questions regarding this collection,
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contact Heather Raeburn at 301–492–
4224.)
6. Type of Information Collection
Request: Revision of a previously
approved information collection; Title
of Information Collection: Patient
Protection and Affordable Care Act;
Consumer Assistance Tools and
Programs of an Exchange and Certified
Application Counselors; Exchange and
Insurance Market Standards for 2015;
Use: Section 1321(a)(1) of the Affordable
Care Act directs and authorizes the
Secretary to issue regulations setting
standards for meeting the requirements
under title I of the Affordable Care Act,
with respect to, among other things, the
establishment and operation of
Exchanges. Pursuant to this authority,
regulations establishing the certified
application counselor program have
been finalized at 45 CFR 155.225. In
accordance with 155.225(d)(1) and (7),
certified application counselors in all
Exchanges are required to be initially
certified and recertified on at least an
annual basis and successfully complete
Exchange-required training. Form
Number: CMS–10494 (OMB Control
Number: 0938–1205); Frequency: On
Occasion; Affected Public: State, Local,
or Tribal Governments, Private Sector
(Not-for-profit institutions); Individuals
or Households; Number of Respondents:
30,000; Number of Responses: 30,000;
Total Annual Hours: 7,500. (For policy
questions regarding this collection,
contact Tricia Beckmann at 301–492–
4328.)
7. Type of Information Collection
Request: New collection (Request for a
new OMB control number); Title of
Information Collection: Generic
Clearance for Questionnaire Testing and
Methodological Research for the
Medicare Current Beneficiary Survey
(MCBS); Use: The purpose of this OMB
clearance package is to clear a Generic
Clearance to support an effort to
evaluate the operations and content of
the Medicare Current Beneficiary
Survey (MCBS). The MCBS is a
continuous, multipurpose survey of a
nationally representative sample of
aged, disabled, and institutionalized
Medicare beneficiaries. The MCBS,
which is sponsored by the Centers for
Medicare & Medicaid Services (CMS), is
the only comprehensive source of
information on the health status, health
care use and expenditures, health
insurance coverage, and socioeconomic
and demographic characteristics of the
entire spectrum of Medicare
beneficiaries.
The core of the MCBS is a series of
interviews with a stratified random
sample of the Medicare population,
including aged and disabled enrollees,
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residing in the community or in
institutions. Questions are asked about
enrollees’ patterns of health care use,
charges, insurance coverage, and
payments over time. Respondents are
asked about their sources of health care
coverage and payment, their
demographic characteristics, their
health and work history, and their
family living circumstances. In addition
to collecting information through the
core questionnaire, the MCBS collects
information on special topics through
supplements. For example, questions
are asked about enrollees’ income and
assets, access to health care, health and
functional status and satisfaction with
care. Special supplements also focus on
emerging trends in health care. Form
Number: CMS–10549 (OMB control
number 0938–New); Frequency:
Occasionally; Affected Public:
Individuals or Households; Number of
Respondents: 1,500; Total Annual
Responses: 1,500; Total Annual Hours:
1,117. (For policy questions regarding
this collection contact William Long at
410–786–7927.)
Dated: January 27, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2015–01790 Filed 1–29–15; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10530, CMS–
1880 and CMS–1882]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
ACTION:
Notice.
The Centers for Medicare &
Medicaid Services (CMS) is announcing
an opportunity for the public to
comment on CMS’ intention to collect
information from the public. Under the
Paperwork Reduction Act of 1995
(PRA), federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension or reinstatement of an existing
collection of information, and to allow
a second opportunity for public
comment on the notice. Interested
persons are invited to send comments
regarding the burden estimate or any
other aspect of this collection of
information, including any of the
SUMMARY:
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Agencies
[Federal Register Volume 80, Number 20 (Friday, January 30, 2015)]
[Notices]
[Pages 5118-5120]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2015-01790]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier CMS-R-306, CMS-10371, CMS-10392, CMS-10418, CMS-
10472, CMS-10494 and CMS-10549]
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 March 31, 2015.
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-R-306 Use of Restraint and Seclusion in Psychiatric Residential
Treatment Facilities (PRTFs) for Individuals Under Age 21 and
Supporting Regulations
CMS-10371 Cooperative Agreements to Support Establishment of State-
Operated Health Insurance Exchanges
CMS-10392 Consumer Operated and Oriented (CO-OP) Program
CMS-10418 Annual MLR and Rebate Calculation Report and MLR Rebate
Notices
CMS-10472 Exchange Functions: Standards for Navigators and Non-
Navigator Assistance
CMS-10494 Standards for Navigators and Non-Navigator Assistance
Personnel; Consumer Assistance Tools and Programs of an Exchange and
Certified Application Counselors
CMS-10549 Generic Clearance for Questionnaire Testing and
Methodological Research for the Medicare Current Beneficiary Survey
(MCBS)
Under the PRA (44 U.S.C. 3501-3520), federal agencies must obtain
approval from the Office of Management and Budget (OMB) for each
collection of information they conduct or sponsor. The term
``collection of information'' is defined in 44 U.S.C. 3502(3) and 5 CFR
1320.3(c) and includes agency requests or requirements that members of
the public submit reports, keep records, or provide information to a
third party. Section 3506(c)(2)(A) of the PRA requires federal agencies
to publish a 60-day notice in the Federal Register concerning each
proposed collection of information, including each proposed extension
or reinstatement of an existing collection of information, before
submitting the collection to OMB for approval. To comply with this
requirement, CMS is publishing this notice.
Information Collection
1. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Use of Restraint
and Seclusion in Psychiatric Residential Treatment Facilities (PRTFs)
for Individuals Under Age 21 and Supporting Regulations; Use:
Psychiatric residential treatment facilities are required to report
deaths, serious injuries and attempted suicides to the State Medicaid
Agency and the Protection and Advocacy Organization. They are also
required to provide residents the restraint and seclusion policy in
writing, and to document in the residents' records all activities
involving the use of restraint and seclusion. Form Number: CMS-R-306
(OMB Control Number 0938-0833); Frequency: Occasionally; Affected
Public: Private sector (Business or other for-profits); Number of
Respondents: 390; Total Annual Responses: 1,466,795; Total Annual
Hours: 431,062. (For policy questions regarding this collection contact
Cindy Ruff at 410-786-5916).
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Cooperative
Agreements to Support Establishment of State-Operated Health Insurance
Exchanges; Use: All States (including the 50 States, consortia of
States, and the District of Columbia herein referred to as States) had
the opportunity under Section 1311(b) of the Affordable Care to apply
for three types of grants: (1) Planning grants; (2) Early Innovator
grants for early development of information technology; and (3)
Establishment grants to develop, implement and start-up Marketplaces.
As of January 1st, 2015, the Secretary has disbursed over $5.4 billion
under
[[Page 5119]]
this grant program and, as of that date, there were 79 active
establishment grants awarded to 28 states. As the State-Based
Marketplaces (SBM) and Small Business Health Options Program (SHOP)
have matured and moved from the developmental phases to full-operation,
the reporting requirements for the states have been modified and
streamlined to insure only information necessary to provide effective
oversight of their operations by CMS is collected. Given the innovative
nature of Exchanges and the statutorily-prescribed relationship between
the Secretary and States in their development and operation, it is
critical that the Secretary work closely with States to provide
necessary guidance and technical assistance to ensure that States can
meet the prescribed timelines, federal requirements, and goals of the
statute and the grants awarded to them. Form Number: CMS-10371 (OMB
Control Number: 0938-1119); Frequency: Once; Affected Public: State
Government agencies, non-profit entities; Number of Respondents: 28;
Number of Responses: 48; Total Annual Hours: 31,404. (For policy
questions regarding this collection contact Dena Pushkin at 301-492-
4342.)
3. Type of Information Collection Request: Revision of a currently
approved information collection; Title of Information Collection:
Consumer Operated and Oriented (CO-OP) Program; Use: The Consumer
Operated and Oriented Plan (CO-OP) program was established by Section
1322 of the Affordable Care Act. This program provides for loans to
establish at least one consumer-operated, qualified nonprofit health
insurance issuer in each State. Issuers supported by the CO-OP program
will offer at least one qualified health plan at the silver level of
benefits and one at the gold level of benefits in the individual market
State Health Benefit Exchanges (Exchanges). At least two-thirds of
policies or contracts offered by a CO-OP will be open to individuals
and small employers. Profits generated by the nonprofit CO-OPs will be
used to lower premiums, improve benefits, improve the quality of health
care delivered to their members, expand enrollment, or otherwise
contribute to the stability of coverage offered by the CO-OP. By
increasing competition in the health insurance market and operating
with a strong consumer focus, the CO-OP program will provide consumers
more choices, greater plan accountability, increased competition to
lower prices, and better models of care, benefiting all consumers, not
just CO-OP members.
The CO-OP program will provide nonprofits with loans to fund start-
up costs and State reserve requirements, in the form of Start-up Loans
and Solvency Loans. An applicant may apply for (1) joint Start-up and
Solvency Loans; or (3) only a Solvency Loan. Planning Loans are
intended to help loan recipients determine the feasibility of operating
a CO-OP in a target market. Start-up Loans are intended to assist loan
recipients with the many start-up costs associated with establishing a
new health insurance issuer. Solvency Loans are intended to assist loan
recipients with meeting the solvency requirements of States in which
the applicant seeks to be licensed to issue qualified health plans.
Form Number: CMS-10392 (OMB control number: 0938-1139); Frequency:
Occasionally; Affected Public: Private sector (Not-for-profit
institutions); Number of Respondents: 23; Total Annual Responses: 675;
Total Annual Hours: 93,220. (For policy questions regarding this
collection contact Deepti Loharikar 301-492-4126).
4. Type of Information Collection Request: Revision of a currently
approved information collection; Title of Information Collection:
Annual MLR and Rebate Calculation Report and MLR Rebate Notices; Use:
Under Section 2718 of the Affordable Care Act and implementing
regulation at 45 CFR part 158, a health insurance issuer (issuer)
offering group or individual health insurance coverage must submit a
report to the Secretary concerning the amount the issuer spends each
year on claims, quality improvement expenses, non-claims costs, Federal
and State taxes and licensing and regulatory fees, the amount of earned
premium, and beginning with the 2014 reporting year, the amounts
related to the transitional reinsurance, risk adjustment, and risk
corridors. An issuer must provide an annual rebate if the amount it
spends on certain costs compared to its premium revenue (excluding
Federal and States taxes and licensing and regulatory fees) does not
meet a certain ratio, referred to as the medical loss ratio (MLR). An
interim final rule (IFR) implementing the MLR was published on December
1, 2010 (75 FR 74865) and modified by technical corrections on December
30, 2010 (75 FR 82277), which added Part 158 to Title 45 of the Code of
Federal Regulations. The IFR is effective January 1, 2011. A final rule
regarding selected provisions of the IFR was published on December 7,
2011 (76 FR 76574, CMS-9998-FC) and an interim final rule regarding an
issue not included in issuers' reporting obligations (disbursement of
rebates by non-federal governmental plans) was also published December
7, 2011 (76 FR 76596, CMS-9998-IFC2). Both rules published on December
7, 2011 are effective January 1, 2012. Each issuer is required to
submit annually MLR data, including information about any rebates it
must provide, on a form prescribed by CMS, for each State in which the
issuer conducts business. Each issuer is also required to provide a
rebate notice to each policyholder that is owed a rebate and each
subscriber of policyholders that are owed a rebate for any given MLR
reporting year. Additionally, each issuer is required to maintain for a
period of seven years all documents, records and other evidence that
support the data included in each issuer's annual report to the
Secretary. Under Section 1342 of the Patient Protection and Affordable
Care Act and implementing regulation at 45 CFR part 153, issuers of
qualified health plans (QHPs) must participate in a risk corridors
program. A QHP issuer is required to pay charges to or receive payments
from CMS based on the ratio of the issuer's allowable costs to the
target amount. A final rule (Premium Stabilization Rule) implementing
the risk corridors program was published on March 23, 2012 (77 FR
17220), which added Part 153 to Title 45 of the Code of Federal
Regulations. The Premium Stabilization Rule is effective May 22, 2012.
Final rules (2014 and 2015 Payment Notices) outlining the risk
corridors benefit and payment parameters for the 2014 and 2015 benefit
years were published on March 11, 2013 (78 FR 15410) and March 11, 2014
(79 FR 13744), respectively. The 2014 and 2015 Payment Notices are
effective April 30, 2013 and May 12, 2014, respectively. Each QHP
issuer is required to submit an annual report to CMS concerning the
issuer's allowable costs, allowable administrative costs, and the
amount of premium.
Based upon our experience in the MLR data collection and evaluation
process, we are updating its annual burden hour estimates to reflect
the actual numbers of submissions, rebates and rebate notices. In
addition, we are updating its annual burden hour estimates to reflect
the additional burden (published in the 2015 Payment Notice) related to
the risk corridors data submission requirements.
The 2014 MLR Reporting Form and instructions reflect changes for
the 2014 reporting year and beyond that are set forth in the March 2013
update to 45 CFR part 158 regarding the MLR reporting and rebate
distribution deadlines and the accounting for the transitional
reinsurance, risk
[[Page 5120]]
adjustment, and risk corridors. The 2014 MLR Reporting Form and
instructions are also modified to include the reporting elements
required under the risk corridors data submission requirements in 45
CFR 153.530. In 2015, it is expected that issuers will send fewer
notices and rebate checks to policyholders and subscribers, which will
reduce burden on issuers. On the other hand, the requirement to report
the risk corridors data will increase burden for QHP issuers. It is
estimated that there will be a net reduction in total burden from
294,911 to 271,600. Form Number: CMS-10418 (OMB control number: 0938-
1164); Frequency: Annually; Affected Public: Private Sector, Business
or other for-profits and not-for-profit institutions; Number of
Respondents: 517; Number of Responses: 3,307; Total Annual Hours:
271,600. (For policy questions regarding this collection, contact Julie
McCune at (301) 492-4196.)
5. Type of Information Collection Request: Revision of a previously
approved information collection; Title of Information Collection:
Patient Protection and Affordable Care Act; Consumer Assistance Tools
and Programs of an Exchange and Certified Application Counselors;
Exchange and Insurance Market Standards for 2015; Use: Section
1321(a)(1) of the Affordable Care Act directs and authorizes the
Secretary to issue regulations setting standards for meeting the
requirements under title I of the Affordable Care Act, with respect to,
among other things, the establishment and operation of Exchanges.
Pursuant to this authority, regulations have been finalized at 45 CFR
155.215(b)(1) to require Navigators, as well as those non-Navigator
personnel to whom 45 CFR 155.215 applies, requires completion of HHS
approved training for initial certification and annual recertification
prior to providing application and enrollment assistance. The training
will include an optional training quality questionnaire providing
Navigators and non-Navigator assistance personnel to whom 45 CFR
155.215 applies, an opportunity to provide feedback to CMS regarding
the training and any improvements that can be made in the future. Form
Number: CMS-10472 (OMB Control Number: 0938-1220); Frequency: On
Occasion; Affected Public: State, Local, or Tribal Governments, Private
Sector (not-for-profit institutions); individuals or households; Number
of Respondents: 5,610; Number of Responses: 5,610; Total Annual Hours:
37,036. (For policy questions regarding this collection, contact
Heather Raeburn at 301-492-4224.)
6. Type of Information Collection Request: Revision of a previously
approved information collection; Title of Information Collection:
Patient Protection and Affordable Care Act; Consumer Assistance Tools
and Programs of an Exchange and Certified Application Counselors;
Exchange and Insurance Market Standards for 2015; Use: Section
1321(a)(1) of the Affordable Care Act directs and authorizes the
Secretary to issue regulations setting standards for meeting the
requirements under title I of the Affordable Care Act, with respect to,
among other things, the establishment and operation of Exchanges.
Pursuant to this authority, regulations establishing the certified
application counselor program have been finalized at 45 CFR 155.225. In
accordance with 155.225(d)(1) and (7), certified application counselors
in all Exchanges are required to be initially certified and recertified
on at least an annual basis and successfully complete Exchange-required
training. Form Number: CMS-10494 (OMB Control Number: 0938-1205);
Frequency: On Occasion; Affected Public: State, Local, or Tribal
Governments, Private Sector (Not-for-profit institutions); Individuals
or Households; Number of Respondents: 30,000; Number of Responses:
30,000; Total Annual Hours: 7,500. (For policy questions regarding this
collection, contact Tricia Beckmann at 301-492-4328.)
7. Type of Information Collection Request: New collection (Request
for a new OMB control number); Title of Information Collection: Generic
Clearance for Questionnaire Testing and Methodological Research for the
Medicare Current Beneficiary Survey (MCBS); Use: The purpose of this
OMB clearance package is to clear a Generic Clearance to support an
effort to evaluate the operations and content of the Medicare Current
Beneficiary Survey (MCBS). The MCBS is a continuous, multipurpose
survey of a nationally representative sample of aged, disabled, and
institutionalized Medicare beneficiaries. The MCBS, which is sponsored
by the Centers for Medicare & Medicaid Services (CMS), is the only
comprehensive source of information on the health status, health care
use and expenditures, health insurance coverage, and socioeconomic and
demographic characteristics of the entire spectrum of Medicare
beneficiaries.
The core of the MCBS is a series of interviews with a stratified
random sample of the Medicare population, including aged and disabled
enrollees, residing in the community or in institutions. Questions are
asked about enrollees' patterns of health care use, charges, insurance
coverage, and payments over time. Respondents are asked about their
sources of health care coverage and payment, their demographic
characteristics, their health and work history, and their family living
circumstances. In addition to collecting information through the core
questionnaire, the MCBS collects information on special topics through
supplements. For example, questions are asked about enrollees' income
and assets, access to health care, health and functional status and
satisfaction with care. Special supplements also focus on emerging
trends in health care. Form Number: CMS-10549 (OMB control number 0938-
New); Frequency: Occasionally; Affected Public: Individuals or
Households; Number of Respondents: 1,500; Total Annual Responses:
1,500; Total Annual Hours: 1,117. (For policy questions regarding this
collection contact William Long at 410-786-7927.)
Dated: January 27, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2015-01790 Filed 1-29-15; 8:45 am]
BILLING CODE 4120-01-P