Agency Information Collection Activities: Proposed Collection; Comment Request, 38187-38189 [2016-13917]
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Federal Register / Vol. 81, No. 113 / Monday, June 13, 2016 / Notices
2. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Electronic
Funds Transfer Authorization
Agreement; Use: The information is
needed to allow providers to receive
funds electronically in their bank
accounts. Form Number: CMS–588
(OMB control number: 0938–0626);
Frequency: On occasion; Affected
Public: Business or other for-profit, Notfor-profit institutions; Number of
Respondents: 45,807; Total Annual
Responses: 45,807; Total Annual Hours:
22,543. (For policy questions regarding
this collection contact Kimberly
McPhillips at 410–786–4645.)
Dated: June 7, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2016–13800 Filed 6–10–16; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–10105, CMS–
10191, CMS–10525, CMS–10623, and CMS–
R–246]
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 require; 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
srobinson on DSK5SPTVN1PROD with NOTICES
SUMMARY:
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automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
DATES: Comments must be received by
August 12, 2016.
ADDRESSES: When commenting, please
reference the document identifier or
OMB control number. To be assured
consideration, comments and
recommendations must be submitted in
any one of the following ways:
1. Electronically. You may send your
comments electronically to https://
www.regulations.gov. Follow the
instructions for ‘‘Comment or
Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) that are accepting
comments.
2. By regular mail. You may mail
written comments to the following
address: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development.
Attention: Document Identifier/OMB
Control Number, 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–10105 National Implementation of
In-Center Hemodialysis CAHPS
Survey
CMS–10191 Medicare Parts C and D
Program Audit Protocols and Data
Requests
CMS–10525 Program of all-Inclusive
Care for the Elderly (PACE) Quality
Data Entry in CMS Health Plan
Monitoring System
CMS–10623 Testing Experience and
Functional Tools Demonstration:
PO 00000
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38187
Personal Health Record (PHR) User
Survey
CMS–R–246 Medicare Advantage,
Medicare Part D, and Medicare FeeFor-Service Consumer Assessment of
Healthcare Providers and Systems
(CAHPS) Survey
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.
1. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: National
Implementation of the In-Center
Hemodialysis CAHPS Survey; Use: Data
collected in the national
implementation of the In-center
Hemodialysis Consumer Assessment of
Healthcare Providers and Systems
(CAHPS) Survey will be used to: (1)
Provide a source of information from
which selected measures can be
publicly reported to beneficiaries as a
decision aid for dialysis facility
selection, (2) aid facilities with their
internal quality improvement efforts
and external benchmarking with other
facilities, (3) provide CMS with
information for monitoring and public
reporting purposes, and (4) support the
end-stage renal disease value-based
purchasing program. Form Number:
CMS–10105 (OMB control number:
0938–0926). Frequency: Occasionally;
Affected Public: Individuals or
households; Number of Respondents:
109,328; Total Annual Responses:
109,328; Total Annual Hours: 59,037.
(For policy questions regarding this
collection contact Elizabeth Goldstein at
410–786–6665.)
2. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare Parts
C and D Program Audit Protocols and
Data Requests; Use: Under the Medicare
Prescription Drug, Improvement, and
E:\FR\FM\13JNN1.SGM
13JNN1
srobinson on DSK5SPTVN1PROD with NOTICES
38188
Federal Register / Vol. 81, No. 113 / Monday, June 13, 2016 / Notices
Modernization Act of 2003 and
implementing regulations at 42 CFR
parts 422 and 423, Medicare Part D plan
sponsors and Medicare Advantage
organizations are required to comply
with all Medicare Parts C and D
program requirements. In 2010, the
explosive growth of these sponsoring
organizations forced CMS to develop an
audit strategy to ensure we continue to
obtain meaningful audit results. As a
result, CMS’ audit strategy reflected a
move to a more targeted, data-driven
and risk-based audit approach. We
focused on high-risk areas that have the
greatest potential for beneficiary harm.
To maximize resources, CMS will
focus on assisting the industry to
improve their operations to ensure
beneficiaries receive access to care. One
way to accomplish this is CMS will
develop an annual audit strategy which
describes how sponsors will be selected
for audit and the areas that will be
audited. CMS has developed several
audit protocols and these are posted to
the CMS Web site each year for use by
sponsors to prepare for their audit.
Currently CMS utilizes the following 7
protocols to audit sponsor performance:
Formulary Administration (FA),
Coverage Determinations, Appeals &
Grievances (CDAG), Organization
Determination, Appeals and Grievances
(ODAG), Special Needs Model of Care
(SNPMOC) (only administered on
organizations who operate SNPs),
Compliance Program Effectiveness
(CPE), Medication Therapy Management
(MTM) and Provider Network Accuracy
(PNA). The data collected is detailed in
each of these protocols and the exact
fields are located in the record layouts,
at the end of each protocol. In addition,
questionnaires are distributed as part of
our CDAG, ODAG and CPE audits.
These questionnaires are also included
in this package.
As part of a robust audit process, CMS
also requires sponsors who have been
audited and found to have deficiencies
to undergo a validation audit to ensure
correction. The validation audit utilizes
the same audit protocols, but only tests
the elements where deficiencies were
found, as opposed to re-administering
the entire audit. Finally, to assist in
improving the audit process, CMS sends
sponsors a link to a survey (Appendix
D) at the end of each audit to complete
in order to obtain the sponsors’
feedback. The sponsor is not required to
complete the survey. Form Number:
CMS–10191 (OMB control number:
0938–1000); Frequency: Yearly; Affected
Public: Private Sector (business or other
for-profit and not-for-profit institutions);
Number of Respondents: 40; Total
Annual Responses: 40; Total Annual
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Hours: 13,640. (For policy questions
regarding this collection contact Dawn
Johnson at 410–786–3159.)
3. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Program of allInclusive Care for the Elderly (PACE)
Quality Data Entry in CMS Health Plan
Monitoring System; Use: PACE
organizations coordinate the care of
each participant enrolled in the program
based on his or her individual needs
with the goal of enabling older
individuals to remain in their
community. To be eligible to enroll in
PACE, an individual must: be 55 or
older, live in the service area of a PACE
organization (PO), need a nursing homelevel of care (as certified by the state in
which he or she lives), and be able to
live safely in the community with
assistance from PACE (42 CFR
460.150(b)).
The PACE program provides
comprehensive care whereby an
interdisciplinary team of health
professionals provides individuals with
coordinated care. The overall quality of
care is analyzed by information
collected and reported to CMS related to
specific quality indicators that may
cause potential or actual harm. CMS
analyzes the quality data to identify
opportunities to improve the quality of
care, safety and PACE sustainability and
growth.
Previously, quality reporting was
identified as Level I or Level II
reporting. Level I reporting
requirements refer to those data
elements that POs regularly report to
CMS via the CMS Health Plan
Management System (HPMS) PACE
monitoring module. (Please see
Appendix A for the list of data
elements.) POs have been collecting,
submitting and reporting data to CMS
and State administering agencies (SAA)
since 1999.
When analyzing the Level I data,
findings may or may not trigger a
Quality Improvement (QI) process of
analysis (e.g., Plan, Do, Study, Act
known as PDSA). Findings may indicate
the need for a change in policies,
procedures, systems, clinical practice or
training. Level II reporting requirements
apply specifically to unusual incidents
that result in serious adverse participant
outcomes, or negative national or
regional notoriety related to PACE.
In this PRA package, we are making
title changes from Level I and Level II
to PACE Quality Data. We are requesting
to update and implement previously
collected PACE data elements known as
Level I and Level II into PACE quality
data. Additionally, we are establishing
PO 00000
Frm 00062
Fmt 4703
Sfmt 4703
three PACE Quality measures adopted
from the National Quality Forum (NQF)
and modified for PACE use. These
modified PACE quarterly measures are
Falls, Falls with Injury, and Pressure
Injury Prevalence/Prevention. Currently,
the existing Level I and Level II
elements have not been tested for
reliability or feasibility. By adopting
NQF defined reliable data collection
process for these elements, certain
existing Level I and Level II elements
will then officially meet quality
measures collection standards. These
measures will be used to improve
quality of care for participants in PACE.
PACE Quality measures will be
implemented via the existing HPMS.
POs will be educated on data criteria,
entry and will report quarterly. Form
Number: CMS–10525 (OMB control
number: 0938–1264); Frequency:
Quarterly and occasionally; Affected
Public: Private sector (Business or other
for-profits and Not-for-profit
institutions); Number of Respondents:
100; Total Annual Responses: 29,500;
Total Annual Hours: 211,500. (For
policy questions regarding this
collection contact Tamika Gladney at
410–786–0648).
4. Type of Information Collection
Request: New collection (Request for a
new OMB control number); Title of
Information Collection: Testing
Experience and Functional Tools
Demonstration: Personal Health Record
(PHR) User Survey; Use: The PHR user
survey is important to the TEFT
Program Evaluation and understanding
the impact of the TEFT PHR on
Medicaid CB–LTSS beneficiaries. The
TEFT evaluation team’s approach
includes monitoring state PHR
implementation efforts and fielding a
follow-up questionnaire to CB–LTSS
program participants that asks about
their experiences using the PHR. The
evaluation seeks to measure the degree
to which the PHR is implemented in an
accessible manner for Medicaid
beneficiaries of CB–LTSS. The survey
also is designed to assess the user
experience of the PHR, including access
and usability, as well as some measures
of user satisfaction and perceived
impacts of PHR use. Form Number:
CMS–10623 (OMB control number:
0938-New); Frequency: Once; Affected
Public: Individuals and households;
Number of Respondents: 824; Total
Annual Responses: 824; Total Annual
Hours: 192,113 (For policy questions
regarding this collection contact Kerry
Lida at 410–786–4826).
5. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare
E:\FR\FM\13JNN1.SGM
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Federal Register / Vol. 81, No. 113 / Monday, June 13, 2016 / Notices
Advantage, Medicare Part D, and
Medicare Fee-For-Service Consumer
Assessment of Healthcare Providers and
Systems (CAHPS) Survey; Use: The
primary purpose of the Medicare
consumer assessment of healthcare
providers and systems (CAHPS) surveys
is to provide information to Medicare
beneficiaries to help them make more
informed choices among health and
prescription drug plans available to
them. The surveys also provides data to
help CMS and others monitor the
quality and performance of Medicare
health and prescription drug plans and
identify areas to improve the quality of
care and services provided to enrollees
of these plans. Form Number: CMS–R–
246 (OMB control number: 0938–0732);
Frequency: Yearly; Affected Public:
Individuals and households; Number of
Respondents: 799,650; Total Annual
Responses: 799,650; Total Annual
Hours: 192,113 (For policy questions
regarding this collection contact Sarah
Gaillot at 410–786–4637).
Dated: June 8, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2016–13917 Filed 6–10–16; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–10066, CMS–
R–193, and CMS–R–282]
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 a 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
following subjects: (1) The necessity and
utility of the proposed information
srobinson on DSK5SPTVN1PROD with NOTICES
SUMMARY:
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Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. The term ‘‘collection of
information’’ is defined in 44 U.S.C.
3502(3) and 5 CFR 1320.3(c) and
includes agency requests or
requirements that members of the public
submit reports, keep records, or provide
information to a third party. Section
3506(c)(2)(A) of the PRA (44 U.S.C.
3506(c)(2)(A)) requires federal agencies
to publish a 30-day notice in the
Federal Register concerning each
proposed collection of information,
including each proposed extension or
reinstatement of an existing collection
of information, before submitting the
collection to OMB for approval. To
comply with this requirement, CMS is
publishing this notice that summarizes
the following proposed collection(s) of
information for public comment:
SUPPLEMENTARY INFORMATION:
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
ACTION:
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 on the collection(s) of
information must be received by the
OMB desk officer by July 13, 2016.
ADDRESSES: When commenting on the
proposed information collections,
please reference the document identifier
or OMB control number. To be assured
consideration, comments and
recommendations must be received by
the OMB desk officer via one of the
following transmissions: OMB, Office of
Information and Regulatory Affairs,
Attention: CMS Desk Officer, Fax
Number: (202) 395–5806 OR Email:
OIRA_submission@omb.eop.gov.
To obtain copies of a supporting
statement and any related forms for the
proposed collection(s) summarized in
this notice, you may make your request
using one of following:
1. Access CMS’ Web site address at
https://www.cms.hhs.gov/Paperwork
ReductionActof1995.
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.
PO 00000
Frm 00063
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38189
1. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Detailed Notice
of Discharge (DND) and Supporting
Regulations in 42 CFR 405.1206 and
422.622; Use: A beneficiary or enrollee
who wishes to appeal a determination
by a Medicare health plan (for a
managed care enrollee) or hospital (for
an original Medicare beneficiary) that
inpatient care is no longer necessary
may request Quality Improvement
Organization (QIO) review of the
determination. On the date the QIO
receives the beneficiary’s/enrollee’s
request, it must notify the plan and
hospital that the beneficiary/enrollee
has filed a request for an expedited
determination. The plan or hospital, in
turn, must deliver a DND to the
enrollee/beneficiary. In this iteration the
DND has been minimally changed to
include language informing
beneficiaries of their rights under the
Rehabilitation Act of 1973 (section 504),
by alerting the beneficiary to CMS’s
nondiscrimination practices and the
availability of alternate forms of this
notice if needed. There are no
substantive changes to the DND form
and instructions. Form Number: CMS–
10066 (OMB control number: 0938–
1019); Frequency: Occasionally;
Affected Public: Private sector (Business
or other for-profit and Not-for-profit
institutions); Number of Respondents:
6,137; Total Annual Responses: 22,515;
Total Annual Hours: 22,515. (For policy
questions regarding this collection
contact Janet Miller at 404–562–1799.)
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Important
Message from Medicare (IM); Use:
Hospitals have used the IM to inform
original Medicare, Medicare Advantage,
and other Medicare plan beneficiaries
who are hospital inpatients about their
hospital rights and discharge rights. In
particular, the IM provides information
about when a beneficiary will and will
not be liable for charges for a continued
stay in a hospital and offers a detailed
description of the Quality Improvement
Organization review process. Please
note that this iteration proposes nonsubstantive changes to the form. Form
Number: CMS–R–193 (OMB control
number: 0938–0692). Frequency: Yearly;
Affected Public: Private sector (Business
or other for-profit and Not-for-profit
institutions); Number of Respondents:
6,142; Total Annual Responses:
23,680,000; Total Annual Hours:
3,404,000. (For policy questions
E:\FR\FM\13JNN1.SGM
13JNN1
Agencies
[Federal Register Volume 81, Number 113 (Monday, June 13, 2016)]
[Notices]
[Pages 38187-38189]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-13917]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-10105, CMS-10191, CMS-10525, CMS-10623, and
CMS-R-246]
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 require; 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 August 12, 2016.
ADDRESSES: When commenting, please reference the document identifier or
OMB control number. To be assured consideration, comments and
recommendations must be submitted in any one of the following ways:
1. Electronically. You may send your comments electronically to
https://www.regulations.gov. Follow the instructions for ``Comment or
Submission'' or ``More Search Options'' to find the information
collection document(s) that are accepting comments.
2. By regular mail. You may mail written comments to the following
address: CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development.
Attention: Document Identifier/OMB Control Number, 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-10105 National Implementation of In-Center Hemodialysis CAHPS
Survey
CMS-10191 Medicare Parts C and D Program Audit Protocols and Data
Requests
CMS-10525 Program of all-Inclusive Care for the Elderly (PACE) Quality
Data Entry in CMS Health Plan Monitoring System
CMS-10623 Testing Experience and Functional Tools Demonstration:
Personal Health Record (PHR) User Survey
CMS-R-246 Medicare Advantage, Medicare Part D, and Medicare Fee-For-
Service Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Survey
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.
1. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: National
Implementation of the In-Center Hemodialysis CAHPS Survey; Use: Data
collected in the national implementation of the In-center Hemodialysis
Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey
will be used to: (1) Provide a source of information from which
selected measures can be publicly reported to beneficiaries as a
decision aid for dialysis facility selection, (2) aid facilities with
their internal quality improvement efforts and external benchmarking
with other facilities, (3) provide CMS with information for monitoring
and public reporting purposes, and (4) support the end-stage renal
disease value-based purchasing program. Form Number: CMS-10105 (OMB
control number: 0938-0926). Frequency: Occasionally; Affected Public:
Individuals or households; Number of Respondents: 109,328; Total Annual
Responses: 109,328; Total Annual Hours: 59,037. (For policy questions
regarding this collection contact Elizabeth Goldstein at 410-786-6665.)
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare Parts C
and D Program Audit Protocols and Data Requests; Use: Under the
Medicare Prescription Drug, Improvement, and
[[Page 38188]]
Modernization Act of 2003 and implementing regulations at 42 CFR parts
422 and 423, Medicare Part D plan sponsors and Medicare Advantage
organizations are required to comply with all Medicare Parts C and D
program requirements. In 2010, the explosive growth of these sponsoring
organizations forced CMS to develop an audit strategy to ensure we
continue to obtain meaningful audit results. As a result, CMS' audit
strategy reflected a move to a more targeted, data-driven and risk-
based audit approach. We focused on high-risk areas that have the
greatest potential for beneficiary harm.
To maximize resources, CMS will focus on assisting the industry to
improve their operations to ensure beneficiaries receive access to
care. One way to accomplish this is CMS will develop an annual audit
strategy which describes how sponsors will be selected for audit and
the areas that will be audited. CMS has developed several audit
protocols and these are posted to the CMS Web site each year for use by
sponsors to prepare for their audit. Currently CMS utilizes the
following 7 protocols to audit sponsor performance: Formulary
Administration (FA), Coverage Determinations, Appeals & Grievances
(CDAG), Organization Determination, Appeals and Grievances (ODAG),
Special Needs Model of Care (SNPMOC) (only administered on
organizations who operate SNPs), Compliance Program Effectiveness
(CPE), Medication Therapy Management (MTM) and Provider Network
Accuracy (PNA). The data collected is detailed in each of these
protocols and the exact fields are located in the record layouts, at
the end of each protocol. In addition, questionnaires are distributed
as part of our CDAG, ODAG and CPE audits. These questionnaires are also
included in this package.
As part of a robust audit process, CMS also requires sponsors who
have been audited and found to have deficiencies to undergo a
validation audit to ensure correction. The validation audit utilizes
the same audit protocols, but only tests the elements where
deficiencies were found, as opposed to re-administering the entire
audit. Finally, to assist in improving the audit process, CMS sends
sponsors a link to a survey (Appendix D) at the end of each audit to
complete in order to obtain the sponsors' feedback. The sponsor is not
required to complete the survey. Form Number: CMS-10191 (OMB control
number: 0938-1000); Frequency: Yearly; Affected Public: Private Sector
(business or other for-profit and not-for-profit institutions); Number
of Respondents: 40; Total Annual Responses: 40; Total Annual Hours:
13,640. (For policy questions regarding this collection contact Dawn
Johnson at 410-786-3159.)
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Program of all-
Inclusive Care for the Elderly (PACE) Quality Data Entry in CMS Health
Plan Monitoring System; Use: PACE organizations coordinate the care of
each participant enrolled in the program based on his or her individual
needs with the goal of enabling older individuals to remain in their
community. To be eligible to enroll in PACE, an individual must: be 55
or older, live in the service area of a PACE organization (PO), need a
nursing home-level of care (as certified by the state in which he or
she lives), and be able to live safely in the community with assistance
from PACE (42 CFR 460.150(b)).
The PACE program provides comprehensive care whereby an
interdisciplinary team of health professionals provides individuals
with coordinated care. The overall quality of care is analyzed by
information collected and reported to CMS related to specific quality
indicators that may cause potential or actual harm. CMS analyzes the
quality data to identify opportunities to improve the quality of care,
safety and PACE sustainability and growth.
Previously, quality reporting was identified as Level I or Level II
reporting. Level I reporting requirements refer to those data elements
that POs regularly report to CMS via the CMS Health Plan Management
System (HPMS) PACE monitoring module. (Please see Appendix A for the
list of data elements.) POs have been collecting, submitting and
reporting data to CMS and State administering agencies (SAA) since
1999.
When analyzing the Level I data, findings may or may not trigger a
Quality Improvement (QI) process of analysis (e.g., Plan, Do, Study,
Act known as PDSA). Findings may indicate the need for a change in
policies, procedures, systems, clinical practice or training. Level II
reporting requirements apply specifically to unusual incidents that
result in serious adverse participant outcomes, or negative national or
regional notoriety related to PACE.
In this PRA package, we are making title changes from Level I and
Level II to PACE Quality Data. We are requesting to update and
implement previously collected PACE data elements known as Level I and
Level II into PACE quality data. Additionally, we are establishing
three PACE Quality measures adopted from the National Quality Forum
(NQF) and modified for PACE use. These modified PACE quarterly measures
are Falls, Falls with Injury, and Pressure Injury Prevalence/
Prevention. Currently, the existing Level I and Level II elements have
not been tested for reliability or feasibility. By adopting NQF defined
reliable data collection process for these elements, certain existing
Level I and Level II elements will then officially meet quality
measures collection standards. These measures will be used to improve
quality of care for participants in PACE. PACE Quality measures will be
implemented via the existing HPMS. POs will be educated on data
criteria, entry and will report quarterly. Form Number: CMS-10525 (OMB
control number: 0938-1264); Frequency: Quarterly and occasionally;
Affected Public: Private sector (Business or other for-profits and Not-
for-profit institutions); Number of Respondents: 100; Total Annual
Responses: 29,500; Total Annual Hours: 211,500. (For policy questions
regarding this collection contact Tamika Gladney at 410-786-0648).
4. Type of Information Collection Request: New collection (Request
for a new OMB control number); Title of Information Collection: Testing
Experience and Functional Tools Demonstration: Personal Health Record
(PHR) User Survey; Use: The PHR user survey is important to the TEFT
Program Evaluation and understanding the impact of the TEFT PHR on
Medicaid CB-LTSS beneficiaries. The TEFT evaluation team's approach
includes monitoring state PHR implementation efforts and fielding a
follow-up questionnaire to CB-LTSS program participants that asks about
their experiences using the PHR. The evaluation seeks to measure the
degree to which the PHR is implemented in an accessible manner for
Medicaid beneficiaries of CB-LTSS. The survey also is designed to
assess the user experience of the PHR, including access and usability,
as well as some measures of user satisfaction and perceived impacts of
PHR use. Form Number: CMS-10623 (OMB control number: 0938-New);
Frequency: Once; Affected Public: Individuals and households; Number of
Respondents: 824; Total Annual Responses: 824; Total Annual Hours:
192,113 (For policy questions regarding this collection contact Kerry
Lida at 410-786-4826).
5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare
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Advantage, Medicare Part D, and Medicare Fee-For-Service Consumer
Assessment of Healthcare Providers and Systems (CAHPS) Survey; Use: The
primary purpose of the Medicare consumer assessment of healthcare
providers and systems (CAHPS) surveys is to provide information to
Medicare beneficiaries to help them make more informed choices among
health and prescription drug plans available to them. The surveys also
provides data to help CMS and others monitor the quality and
performance of Medicare health and prescription drug plans and identify
areas to improve the quality of care and services provided to enrollees
of these plans. Form Number: CMS-R-246 (OMB control number: 0938-0732);
Frequency: Yearly; Affected Public: Individuals and households; Number
of Respondents: 799,650; Total Annual Responses: 799,650; Total Annual
Hours: 192,113 (For policy questions regarding this collection contact
Sarah Gaillot at 410-786-4637).
Dated: June 8, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2016-13917 Filed 6-10-16; 8:45 am]
BILLING CODE 4120-01-P