Agency Information Collection Activities: Submission for OMB Review; Comment Request, 87039-87041 [2016-29007]
Download as PDF
Federal Register / Vol. 81, No. 232 / Friday, December 2, 2016 / Notices
Leroy A. Richardson,
Chief, Information Collection Review Office,
Office of Scientific Integrity, Office of the
Associate Director for Science, Office of the
Director, Centers for Disease Control and
Prevention.
[FR Doc. 2016–28899 Filed 12–1–16; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–R–26]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services.
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: The
necessity and utility of the proposed
information collection for the proper
performance of the agency’s functions;
the accuracy of the estimated burden;
ways to enhance the quality, utility, and
clarity of the information to be
collected; and the use of automated
collection techniques or other forms of
information technology to minimize the
information collection burden.
DATES: Comments must be received by
January 31, 2017.
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.
asabaliauskas on DSK3SPTVN1PROD with NOTICES
SUMMARY:
VerDate Sep<11>2014
17:55 Dec 01, 2016
Jkt 241001
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/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.
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–26 Clinical Laboratory
Improvement Amendments (CLIA)
Regulations
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: Revision of a currently
approved collection; Title of
Information Collection: Clinical
PO 00000
Frm 00023
Fmt 4703
Sfmt 4703
87039
Laboratory Improvement Amendments
(CLIA) Regulations; Use: The
information is necessary to determine
an entity’s compliance with the
Congressionally-mandated program
with respect to the regulation of
laboratory testing (CLIA). In addition,
laboratories participating in the
Medicare program must comply with
CLIA requirements as required by
section 6141 of OBRA 89. Medicaid,
under the authority of section
1902(a)(9)(C) of the Social Security Act,
pays for services furnished only by
laboratories that meet Medicare (CLIA)
requirements. Form Number: CMS–R–
26 (OMB Control Number: 0938–0612);
Frequency: Monthly, occasionally;
Affected Public: Private sector—
Business or other for-profits and Notfor-profit institutions, State, Local or
Tribal Governments, and the Federal
government; Number of Respondents:
70,861; Total Annual Responses:
1,979,300; Total Annual Hours:
14,975,785. (For policy questions
regarding this collection contact Raelene
Perfetto at 410–786–6876).
Dated: November 29, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2016–29011 Filed 12–1–16; 8:45 am]
BILLING CODE 4120–01– P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–10340, CMS–
10476, CMS–10525, and CMS–10630]
Agency Information Collection
Activities: Submission for OMB
Review; 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
(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
SUMMARY:
E:\FR\FM\02DEN1.SGM
02DEN1
87040
Federal Register / Vol. 81, No. 232 / Friday, December 2, 2016 / Notices
other aspect of this collection of
information, including any of the
following subjects: The necessity and
utility of the proposed information
collection for the proper performance of
the agency’s functions; the accuracy of
the estimated burden; ways to enhance
the quality, utility, and clarity of the
information to be collected; and the use
of automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
Comments on the collection(s) of
information must be received by the
OMB desk officer by January 3, 2017.
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.
DATES:
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
asabaliauskas on DSK3SPTVN1PROD with NOTICES
SUPPLEMENTARY INFORMATION:
VerDate Sep<11>2014
17:55 Dec 01, 2016
Jkt 241001
comply with this requirement, CMS is
publishing this notice that summarizes
the following proposed collection(s) of
information for public comment:
1. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Collection of
Encounter Data From: Medicare
Advantage Organizations, Section 1876
Cost HMOS/CMPS, Section 1833 Health
Care Prepayment Plans (HCPPS), and
PACE Organizations; Use: We collect
encounter data or data on each item or
service delivered to enrollees of
Medicare Advantage (MA) plans offered
by MA organizations. The MA
organizations currently obtain this data
from providers. We collect this
information using standard transaction
forms and code sets. We will use the
data for determining risk adjustment
factors for payment, updating the risk
adjustment model, calculating Medicare
DSH percentages, Medicare coverage
purposes, and quality review and
improvement activities. The data is also
used to verify the accuracy and validity
of the costs claimed on cost reports. For
PACE organizations, encounter data
would serve the same purpose it does
related to the MA program and would
be submitted in a similar manner. Form
Number: CMS–10340 (OMB control
number: 0938–1152); Frequency:
Weekly, bi-weekly, and monthly;
Affected Public: Private sector (Business
or other for-profits); Number of
Respondents: 691; Total Annual
Responses: 18,854,605; Total Annual
Hours: 54,054. (For policy questions
regarding this collection contact
Michael Massimini at 410–786–1566.)
2. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medical Loss
Ratio (MLR) Report for Medicare
Advantage (MA) Plans and Prescription
Drug Plans (PDP); Use: We will use the
data collection of annual reports
provided by plan sponsors for each
contract to ensure that beneficiaries are
receiving value for their premium dollar
by calculating each contract’s medical
loss ratio (MLR) and any remittances
due for the respective MLR reporting
year. The recordkeeping requirements
will be used to determine plan sponsors’
compliance with the MLR requirements,
including compliance with how plan
sponsors’ experience is to be reported,
and how their MLR and any remittances
are calculated. Form Number: CMS–
10476 (OMB control number: 0938–
1232); Frequency: Yearly; Affected
Public: Private sector (Business or other
for-profits and Not-for-profit
institutions); Number of Respondents:
PO 00000
Frm 00024
Fmt 4703
Sfmt 4703
616; Total Annual Responses: 616; Total
Annual Hours: 130,004. (For policy
questions regarding this collection
contact Diane Spitalnic at 410–786–
5745.)
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
E:\FR\FM\02DEN1.SGM
02DEN1
asabaliauskas on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 81, No. 232 / Friday, December 2, 2016 / Notices
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: The PACE
Organization (PO) Monitoring and Audit
Process in 42 CFR part 460; Use:
Historically, the Programs of AllInclusive Care for the Elderly (PACE)
audit protocols have been included in
the Medicare Advantage (MA) and
Medicare Part D audit protocol’s
information collection request (CMS–
10191, OMB 0938–1000). However, in
examining previous submissions, we do
not believe that including it with the
MA and Part D audit protocols allowed
for an accurate representation of the
PACE burden. Due to PACE audits being
substantially different from our MA and
Part D audits, we have separated the
PACE audit protocols from the MA and
Part D protocols and created this
information collection request which
seeks OMB approval under a new
control number.
POs are required to comply with all
PACE program requirements. The
growth of these PACE 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
outcomes-based audit approach. We
focused on high-risk areas that have the
greatest potential for participant harm.
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17:55 Dec 01, 2016
Jkt 241001
CMS has developed an audit protocol
and will post it to the CMS Web site
each year for use by POs to prepare for
their audit. The data collected for audit
is detailed in this protocol and the exact
fields are located in the record layouts,
at the end of the protocol. In addition,
a questionnaire will be distributed as
part of our audit. This questionnaire is
also included in this package. Form
Number: CMS–10630 (OMB control
number: 0938—New); Frequency:
Yearly; Affected Public: Private sector
(Business or other for-profits and Notfor-profits institutions); Number of
Respondents: 72; Total Annual
Responses: 72; Total Annual Hours:
12,960. (For policy questions regarding
this collection contact Caroline Zeman
at 410–786–0116.)
Dated: November 29, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2016–29007 Filed 12–1–16; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket Nos. FDA–2015–E–3158; FDA–
2015–E–3159]
Determination of Regulatory Review
Period for Purposes of Patent
Extension; TRUMENBA
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
The Food and Drug
Administration (FDA) has determined
the regulatory review period for
TRUMENBA and is publishing this
notice of that determination as required
by law. FDA has made the
determination because of the
submission of an application to the
Director of the U.S. Patent and
Trademark Office (USPTO), Department
of Commerce, for the extension of a
patent which claims that human
biological product.
DATES: Anyone with knowledge that any
of the dates as published (see the
SUPPLEMENTARY INFORMATION section) are
incorrect may submit either electronic
or written comments and ask for a
redetermination by January 31, 2017.
Furthermore, any interested person may
petition FDA for a determination
regarding whether the applicant for
extension acted with due diligence
during the regulatory review period by
May 31, 2017. See ‘‘Petitions’’ in the
SUMMARY:
PO 00000
Frm 00025
Fmt 4703
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87041
SUPPLEMENTARY INFORMATION section for
more information.
ADDRESSES: You may submit comments
as follows:
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal:
https://www.regulations.gov. Follow the
instructions for submitting comments.
Comments submitted electronically,
including attachments, to https://
www.regulations.gov will be posted to
the docket unchanged. Because your
comment will be made public, you are
solely responsible for ensuring that your
comment does not include any
confidential information that you or a
third party may not wish to be posted,
such as medical information, your or
anyone else’s Social Security number, or
confidential business information, such
as a manufacturing process. Please note
that if you include your name, contact
information, or other information that
identifies you in the body of your
comments, that information will be
posted on https://www.regulations.gov.
• If you want to submit a comment
with confidential information that you
do not wish to be made available to the
public, submit the comment as a
written/paper submission and in the
manner detailed (see ‘‘Written/Paper
Submissions’’ and ‘‘Instructions’’).
Written/Paper Submissions
Submit written/paper submissions as
follows:
• Mail/Hand delivery/Courier (for
written/paper submissions): Division of
Dockets Management (HFA–305), Food
and Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
• For written/paper comments
submitted to the Division of Dockets
Management, FDA will post your
comment, as well as any attachments,
except for information submitted,
marked and identified, as confidential,
if submitted as detailed in
‘‘Instructions.’’
Instructions: All submissions received
must include the Docket Nos. FDA–
2015–E–3158 and FDA–2015–E–3159
for ‘‘Determination of Regulatory
Review Period for Purposes of Patent
Extension; TRUMENBA.’’ Received
comments will be placed in the docket
and, except for those submitted as
‘‘Confidential Submissions,’’ publicly
viewable at https://www.regulations.gov
or at the Division of Dockets
Management between 9 a.m. and 4 p.m.,
Monday through Friday.
• Confidential Submissions—To
submit a comment with confidential
information that you do not wish to be
E:\FR\FM\02DEN1.SGM
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Agencies
[Federal Register Volume 81, Number 232 (Friday, December 2, 2016)]
[Notices]
[Pages 87039-87041]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-29007]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-10340, CMS-10476, CMS-10525, and CMS-10630]
Agency Information Collection Activities: Submission for OMB
Review; 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 (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
[[Page 87040]]
other aspect of this collection of information, including any of the
following subjects: The necessity and utility of the proposed
information collection for the proper performance of the agency's
functions; the accuracy of the estimated burden; ways to enhance the
quality, utility, and clarity of the information to be collected; and
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 January 3, 2017.
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/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: 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:
1. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Collection of
Encounter Data From: Medicare Advantage Organizations, Section 1876
Cost HMOS/CMPS, Section 1833 Health Care Prepayment Plans (HCPPS), and
PACE Organizations; Use: We collect encounter data or data on each item
or service delivered to enrollees of Medicare Advantage (MA) plans
offered by MA organizations. The MA organizations currently obtain this
data from providers. We collect this information using standard
transaction forms and code sets. We will use the data for determining
risk adjustment factors for payment, updating the risk adjustment
model, calculating Medicare DSH percentages, Medicare coverage
purposes, and quality review and improvement activities. The data is
also used to verify the accuracy and validity of the costs claimed on
cost reports. For PACE organizations, encounter data would serve the
same purpose it does related to the MA program and would be submitted
in a similar manner. Form Number: CMS-10340 (OMB control number: 0938-
1152); Frequency: Weekly, bi-weekly, and monthly; Affected Public:
Private sector (Business or other for-profits); Number of Respondents:
691; Total Annual Responses: 18,854,605; Total Annual Hours: 54,054.
(For policy questions regarding this collection contact Michael
Massimini at 410-786-1566.)
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medical Loss
Ratio (MLR) Report for Medicare Advantage (MA) Plans and Prescription
Drug Plans (PDP); Use: We will use the data collection of annual
reports provided by plan sponsors for each contract to ensure that
beneficiaries are receiving value for their premium dollar by
calculating each contract's medical loss ratio (MLR) and any
remittances due for the respective MLR reporting year. The
recordkeeping requirements will be used to determine plan sponsors'
compliance with the MLR requirements, including compliance with how
plan sponsors' experience is to be reported, and how their MLR and any
remittances are calculated. Form Number: CMS-10476 (OMB control number:
0938-1232); Frequency: Yearly; Affected Public: Private sector
(Business or other for-profits and Not-for-profit institutions); Number
of Respondents: 616; Total Annual Responses: 616; Total Annual Hours:
130,004. (For policy questions regarding this collection contact Diane
Spitalnic at 410-786-5745.)
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
[[Page 87041]]
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: The
PACE Organization (PO) Monitoring and Audit Process in 42 CFR part 460;
Use: Historically, the Programs of All-Inclusive Care for the Elderly
(PACE) audit protocols have been included in the Medicare Advantage
(MA) and Medicare Part D audit protocol's information collection
request (CMS-10191, OMB 0938-1000). However, in examining previous
submissions, we do not believe that including it with the MA and Part D
audit protocols allowed for an accurate representation of the PACE
burden. Due to PACE audits being substantially different from our MA
and Part D audits, we have separated the PACE audit protocols from the
MA and Part D protocols and created this information collection request
which seeks OMB approval under a new control number.
POs are required to comply with all PACE program requirements. The
growth of these PACE 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 outcomes-based audit approach. We focused on high-risk areas
that have the greatest potential for participant harm.
CMS has developed an audit protocol and will post it to the CMS Web
site each year for use by POs to prepare for their audit. The data
collected for audit is detailed in this protocol and the exact fields
are located in the record layouts, at the end of the protocol. In
addition, a questionnaire will be distributed as part of our audit.
This questionnaire is also included in this package. Form Number: CMS-
10630 (OMB control number: 0938--New); Frequency: Yearly; Affected
Public: Private sector (Business or other for-profits and Not-for-
profits institutions); Number of Respondents: 72; Total Annual
Responses: 72; Total Annual Hours: 12,960. (For policy questions
regarding this collection contact Caroline Zeman at 410-786-0116.)
Dated: November 29, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2016-29007 Filed 12-1-16; 8:45 am]
BILLING CODE 4120-01-P