Agency Information Collection Activities: Submission for OMB Review; Comment Request, 11222-11224 [2017-03369]

Download as PDF 11222 Federal Register / Vol. 82, No. 33 / Tuesday, February 21, 2017 / Notices 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 March 23, 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 Board of Governors of the Federal Reserve statement and any related forms for the System, February 14, 2017. proposed collection(s) summarized in Yao-Chin Chao, this notice, you may make your request Assistant Secretary of the Board. using one of following: [FR Doc. 2017–03258 Filed 2–17–17; 8:45 am] 1. Access CMS’ Web site address at BILLING CODE 6210–01–P http://www.cms.hhs.gov/ PaperworkReductionActof1995. 2. Email your request, including your DEPARTMENT OF HEALTH AND address, phone number, OMB number, HUMAN SERVICES and CMS document identifier, to Paperwork@cms.hhs.gov. Centers for Medicare & Medicaid 3. Call the Reports Clearance Office at Services (410) 786–1326. FOR FURTHER INFORMATION CONTACT: [Document Identifiers: CMS–10487, CMS– R–71, CMS–10171, CMS–10260, CMS–10275, Reports Clearance Office at (410) 786– CMS–10396, and CMS–R–266] 1326. SUPPLEMENTARY INFORMATION: Under the Agency Information Collection Paperwork Reduction Act of 1995 (PRA) Activities: Submission for OMB (44 U.S.C. 3501–3520), federal agencies Review; Comment Request must obtain approval from the Office of Management and Budget (OMB) for each AGENCY: Centers for Medicare & collection of information they conduct Medicaid Services, HHS. or sponsor. The term ‘‘collection of ACTION: Notice. information’’ is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is announcing includes agency requests or requirements that members of the public an opportunity for the public to submit reports, keep records, or provide comment on CMS’ intention to collect information to a third party. Section information from the public. Under the 3506(c)(2)(A) of the PRA (44 U.S.C. Paperwork Reduction Act of 1995 3506(c)(2)(A)) requires federal agencies (PRA), federal agencies are required to to publish a 30-day notice in the publish notice in the Federal Register Federal Register concerning each concerning each proposed collection of proposed collection of information, information, including each proposed extension or reinstatement of an existing including each proposed extension or reinstatement of an existing collection collection of information, and to allow of information, before submitting the a second opportunity for public collection to OMB for approval. To comment on the notice. Interested comply with this requirement, CMS is persons are invited to send comments publishing this notice that summarizes regarding the burden estimate or any the following proposed collection(s) of other aspect of this collection of information, including the necessity and information for public comment: sradovich on DSK3GMQ082PROD with NOTICES Unless otherwise noted, comments regarding the applications must be received at the Reserve Bank indicated or the offices of the Board of Governors not later than March 7, 2017. A. Federal Reserve Bank of Philadelphia (William Spaniel, Senior Vice President) 100 North 6th Street, Philadelphia, Pennsylvania 19105– 1521. Comments can also be sent electronically to Comments.applications@phil.frb.org: 1. The Toronto-Dominion Bank, Toronto, Ontario, Canada, and its wholly owned subsidiaries, TD Group US Holdings, LLC, Wilmington, Delaware; TD Bank US Holding Company, Cherry Hill, New Jersey; and TD Bank N.A., Wilmington, Delaware; to acquire Scottrade Financial Services, Inc., St. Louis, Missouri, a savings and loan holding company, and to merge Scottrade Bank, St. Louis, Missouri, a federal savings association, into TD Bank N.A. VerDate Sep<11>2014 17:15 Feb 17, 2017 Jkt 241001 PO 00000 Frm 00052 Fmt 4703 Sfmt 4703 1. Type of Information Collection Request: Extension of a previously approved collection; Title of Information Collection: Medicaid Emergency Psychiatric Demonstration (MEPD) Evaluation; Use: Since the inception of Medicaid, inpatient care provided to adults ages 21 to 64 in institutions for mental disease (IMDs) has been excluded from federal matching funds. The Emergency Medical Treatment and Active Labor Act (EMTALA), however, requires IMDs that participate in Medicare to provide treatment for psychiatric emergency medical conditions (EMCs), even for Medicaid patients for whose services cannot be reimbursed. Section 2707 of the Affordable Care Act (ACA) directs the Secretary of Health and Human Services to conduct and evaluate a demonstration project to determine the impact of providing payment under Medicaid for inpatient services provided by private IMDs to individuals with emergency psychiatric conditions between the ages of 21 and 64. We will use the data to evaluate the Medicaid Emergency Psychiatric Demonstration (MEPD) in accordance with the ACA mandates. This evaluation in turn will be used by Congress to determine whether to continue or expand the demonstration. If the decision is made to expand the demonstration, the data collected will help to inform both CMS and its stakeholders about possible effects of contextual factors and important procedural issues to consider in the expansion, as well as the likelihood of various outcomes. Form Number: CMS–10487 (OMB control number: 0938–NEW); Frequency: Annually; Affected Public: Individuals and households; State, Local and Tribal governments; Business and other forprofits and Not-for-profits; Number of Respondents: 93; Total Annual Responses: 1,944; Total Annual Hours: 2,046. (For policy questions regarding this collection contact Vetisha McClair at 410–786–4923.) 2. Type of Information Collection Request: Extension of a previously approved collection; Title of Information Collection: Quality Improvement Organization (QIO) Assumption of Responsibilities and Supporting Regulations; Use: The Peer Review Improvement Act of 1982 amended Title XI of the Social Security Act to create the Utilization and Quality Control Peer Review Organization (PRO) program which replaces the Professional Standards Review Organization (PSRO) program and streamlines peer review activities. The term PRO has been renamed Quality Improvement E:\FR\FM\21FEN1.SGM 21FEN1 sradovich on DSK3GMQ082PROD with NOTICES Federal Register / Vol. 82, No. 33 / Tuesday, February 21, 2017 / Notices Organization (QIO). This information collection describes the review functions to be performed by the QIO. It outlines relationships among QIOs, providers, practitioners, beneficiaries, intermediaries, and carriers. Form Number: CMS–R–71 (OMB Control Number: 0938–0445); Frequency: Yearly; Affected Public: Business or other for-profit and Not-for-profit institutions; Number of Respondents: 6,939; Total Annual Responses: 489,750; Total Annual Hours: 1,479,346. (For policy questions regarding this collection contact Tennille Coombs at 410–786–3472.) 3. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Collecting Benefit Coordination Data; Use: This collection of information request coordinates Part D plan prescription drug coverage with other prescription drug coverage. The collected information will assist CMS, Part D plans and other payers with coordination of prescription drug benefits at the point-of-sale and tracking of the beneficiary’s True out-of-pocket (TrOOP) expenditures using the Part D Transaction Facilitator (PDTF). Form Number: CMS–10171 (OMB control number: 0938–0978); Frequency: Yearly and occasionally; Affected Public: Business or other for-profits; Number of Respondents: 62,438; Total Annual Responses: 891,777,634; Total Annual Hours: 5,201,718. (For policy questions regarding this collection contact Shelly Winston at 410–786–3694.) 4. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: Medicare Advantage and Prescription Drug Program: Final Marketing Provisions in 42 CFR 422.111(a)(3) and 423.128(a)(3); Use: We require that Medicare Advantage (MA) organizations and Part D sponsors use standardized documents to satisfy disclosure requirements mandated by section 1851(d)(3)(A) of the Social Security Act (Act) and 42 CFR 422.111(b) for MA organizations, and section 1860D–1(c) of the Act and 42 CFR 423.128(a)(3) for Part D sponsors. The regulatory provisions require that MA organizations and Part D sponsors disclose plan information, including: Service area, benefits, access, grievance and appeals procedures, and quality improvement and quality assurance requirements by September 30th of each year. The MA organizations and Part D sponsors use the information to comply with the disclosure requirements. We will use the approved standardized documents to ensure that VerDate Sep<11>2014 17:15 Feb 17, 2017 Jkt 241001 correct information is disclosed to current and potential enrollees. For 2017, CMS has a total of nine standardized ANOC/EOC documents: Health Maintenance Organization, Cost, Dual Eligible Special Needs, Medicare Medical Savings Account, Private-FeeFor-Service, Preferred Provider Organizations, Preferred Provider Organization with Prescription Drugs, Health Maintenance Organization with Prescription Drug, and Prescription Drug. These standardized documents will be used by MA organizations and Part D sponsors for the 2018 contract year. In revising the standardized ANOC/ EOCs for contract year 2018, we did not add to or remove any section from the prior contract year ANOC/EOC models. MA organizations and Part D sponsors are still required to use the standardized language in the ANOC/EOC models and to send this document to current members at least 15 days prior to the start of the annual enrollment period or by September 30, 2017 for the 2018 enrollment season, based on 42 CFR 422.111(a) (3) and 423.128(a)(3). Form Number: CMS–10260 (OMB control number: 0938–1051); Frequency: Yearly; Affected Public: Private sector (Business or other for-profits); Number of Respondents: 805; Total Annual Responses: 805; Total Annual Hours: 9,660. (For policy questions regarding this collection contact Gladys Valentin at 410–786–1620.) 5. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: CAHPS Home Health Care Survey; Use: The national implementation of the Home Health Care Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey is designed to collect ongoing data from samples of home health care patients who receive skilled services from Medicare-certified home health agencies. The data collected from the national implementation of the Home Health Care CAHPS Survey will be used for the following purposes: (1) To produce comparable data on the patients’ perspectives of the care they receive from home health agencies, (2) to create incentives for agencies to improve the quality of care they provide through public reporting of survey results, and (3) to enhance public accountability in health care by increasing the transparency of the quality of care provided in return for the public investment. Sampling and data collection will be conducted on a monthly basis. Survey results will be analyzed and reported on a quarterly PO 00000 Frm 00053 Fmt 4703 Sfmt 4703 11223 basis, with publicly reported results based on one year’s worth of data. As part of this information collection request for the national implementation of Home Health Care CAHPS, CMS is also requesting approval to conduct a randomized mode experiment with a sample of home health agencies. The mode experiment compared the responses to the survey across the three proposed modes to determine whether adjustments are needed to ensure that the data collection mode does not influence the survey results. In addition, data from the mode experiment will be used to determine which, if any, patient characteristics may affect the patients’ rating of the care they receive and, if so, develop an adjustment model of those data based on those factors. CMS worked with RTI, the federal contractor to recruit approximately 100 home health agencies to participate in the mode experiment. The mode experiment included approximately 23,000 home health care patients. Form Number: CMS–10275 (OMB control number: 0938–1066); Frequency: Quarterly; Affected Public: Individuals and households, Business or other forprofit and Not-for-profit institutions; Number of Respondents: 2,715,890; Total Annual Responses: 2,715,890; Total Annual Hours: 699,440. (For policy questions regarding this collection contact Lori Teichman at 410–786–6684.) 6. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Medication Therapy Management Program Improvements; Use: Information collected by Part D medication therapy management programs (as required by the standardized format for the comprehensive medication review summary) will be used by beneficiaries or their authorized representatives, caregivers, and their healthcare providers to improve medication use and achieve better healthcare outcomes. Form Number: CMS–10396 (OMB control number 0938–1154); Frequency: Occasionally; Affected Public: Business or other for-profits; Number of Respondents: 599; Total Annual Responses: 1,211,661; Total Annual Hours: 807,451. (For policy questions regarding this collection contact Victoria Dang at 410–786–3991.) 7. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Medicaid Disproportionate Share Hospital (DSH) Annual Reporting Requirements; Use: States are required to submit an annual report that identifies each E:\FR\FM\21FEN1.SGM 21FEN1 11224 Federal Register / Vol. 82, No. 33 / Tuesday, February 21, 2017 / Notices disproportionate share hospital (DSH) that received a DSH payment under the state’s Medicaid program in the preceding fiscal year and the amount of DSH payments paid to that hospital in the same year along with other information that the Secretary determines necessary to ensure the appropriateness of DSH payments; Form Number: CMS–R–266 (OMB control number: 0938–0746); Frequency: Yearly; Affected Public: State, Local, or Tribal Governments; Number of Respondents: 51; Total Annual Responses: 51; Total Annual Hours: 2,142. (For policy questions regarding this collection contact Robert Lane at 410–786–2015.) Dated: February 15, 2017. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2017–03369 Filed 2–17–17; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifier: CMS–10398] Agency Information Collection Activities: Proposed Collection; Comment Request Centers for Medicare & Medicaid Services, Department of Health and Human 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 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. sradovich on DSK3GMQ082PROD with NOTICES SUMMARY: VerDate Sep<11>2014 17:15 Feb 17, 2017 Jkt 241001 Comments must be received by April 24, 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 http:// 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 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 http://www.cms.hhs.gov/ PaperworkReductionActof1995. 2. Email your request, including your address, phone number, OMB number, and CMS document identifier, to Paperwork@cms.hhs.gov. 3. Call the Reports Clearance Office at (410) 786–1326. FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786– 1326. DATES: SUPPLEMENTARY INFORMATION: Contents This notice sets out a summary of the use and burden associated with the following information collections. More detailed information can be found in each collection’s supporting statement and associated materials (see ADDRESSES). CMS–10398 Reconciliation of State Invoice and Prior Quarter Adjustment Statement 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 PO 00000 Frm 00054 Fmt 4703 Sfmt 9990 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: Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions; Use: State Medicaid and CHIP agencies are responsible for developing submissions to CMS, including state plan amendments and requests for waivers and program demonstrations. States use templates when they are available and submit the forms to review for consistency with statutory and regulatory requirements (or in the case of waivers and demonstrations whether the proposal is likely to promote the objectives of the Medicaid program). If the requirements are met, we approve the states’ submissions giving them the authority to implement the flexibilities. For a state to receive Medicaid Title XIX funding, there must be an approved Title XIX state plan. The development of streamlined submissions forms enhances the collaboration and partnership between states and CMS by documenting our policy for states to use as they are developing program changes. Streamlined forms improve efficiency of administration by creating a common and user-friendly understanding of the information we need to quickly process requests for state plan amendments, waivers, and demonstration, as well as ongoing reporting. Form Number: CMS–10398 (OMB control number: 0938–1148); Frequency: Collection-specific, but generally the frequency is yearly, once, and occasionally; Affected Public: State, Local, or Tribal Governments; Number of Respondents: 56; Total Responses: 1,540 (3-year total); Total Hours: 214,584 (3-year total). (For policy questions regarding this collection contact Annette Pearson at 410–786– 6858.) Dated: February 15, 2017. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2017–03370 Filed 2–17–17; 8:45 am] BILLING CODE 4120–01–P E:\FR\FM\21FEN1.SGM 21FEN1

Agencies

[Federal Register Volume 82, Number 33 (Tuesday, February 21, 2017)]
[Notices]
[Pages 11222-11224]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-03369]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-10487, CMS-R-71, CMS-10171, CMS-10260, CMS-
10275, CMS-10396, and CMS-R-266]


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 other aspect of this 
collection of information, including 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 March 23, 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 http://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: Extension of a 
previously approved collection; Title of Information Collection: 
Medicaid Emergency Psychiatric Demonstration (MEPD) Evaluation; Use: 
Since the inception of Medicaid, inpatient care provided to adults ages 
21 to 64 in institutions for mental disease (IMDs) has been excluded 
from federal matching funds. The Emergency Medical Treatment and Active 
Labor Act (EMTALA), however, requires IMDs that participate in Medicare 
to provide treatment for psychiatric emergency medical conditions 
(EMCs), even for Medicaid patients for whose services cannot be 
reimbursed. Section 2707 of the Affordable Care Act (ACA) directs the 
Secretary of Health and Human Services to conduct and evaluate a 
demonstration project to determine the impact of providing payment 
under Medicaid for inpatient services provided by private IMDs to 
individuals with emergency psychiatric conditions between the ages of 
21 and 64. We will use the data to evaluate the Medicaid Emergency 
Psychiatric Demonstration (MEPD) in accordance with the ACA mandates. 
This evaluation in turn will be used by Congress to determine whether 
to continue or expand the demonstration. If the decision is made to 
expand the demonstration, the data collected will help to inform both 
CMS and its stakeholders about possible effects of contextual factors 
and important procedural issues to consider in the expansion, as well 
as the likelihood of various outcomes. Form Number: CMS-10487 (OMB 
control number: 0938-NEW); Frequency: Annually; Affected Public: 
Individuals and households; State, Local and Tribal governments; 
Business and other for-profits and Not-for-profits; Number of 
Respondents: 93; Total Annual Responses: 1,944; Total Annual Hours: 
2,046. (For policy questions regarding this collection contact Vetisha 
McClair at 410-786-4923.)
    2. Type of Information Collection Request: Extension of a 
previously approved collection; Title of Information Collection: 
Quality Improvement Organization (QIO) Assumption of Responsibilities 
and Supporting Regulations; Use: The Peer Review Improvement Act of 
1982 amended Title XI of the Social Security Act to create the 
Utilization and Quality Control Peer Review Organization (PRO) program 
which replaces the Professional Standards Review Organization (PSRO) 
program and streamlines peer review activities. The term PRO has been 
renamed Quality Improvement

[[Page 11223]]

Organization (QIO). This information collection describes the review 
functions to be performed by the QIO. It outlines relationships among 
QIOs, providers, practitioners, beneficiaries, intermediaries, and 
carriers. Form Number: CMS-R-71 (OMB Control Number: 0938-0445); 
Frequency: Yearly; Affected Public: Business or other for-profit and 
Not-for-profit institutions; Number of Respondents: 6,939; Total Annual 
Responses: 489,750; Total Annual Hours: 1,479,346. (For policy 
questions regarding this collection contact Tennille Coombs at 410-786-
3472.)
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Collecting 
Benefit Coordination Data; Use: This collection of information request 
coordinates Part D plan prescription drug coverage with other 
prescription drug coverage. The collected information will assist CMS, 
Part D plans and other payers with coordination of prescription drug 
benefits at the point-of-sale and tracking of the beneficiary's True 
out-of-pocket (TrOOP) expenditures using the Part D Transaction 
Facilitator (PDTF). Form Number: CMS-10171 (OMB control number: 0938-
0978); Frequency: Yearly and occasionally; Affected Public: Business or 
other for-profits; Number of Respondents: 62,438; Total Annual 
Responses: 891,777,634; Total Annual Hours: 5,201,718. (For policy 
questions regarding this collection contact Shelly Winston at 410-786-
3694.)
    4. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Medicare 
Advantage and Prescription Drug Program: Final Marketing Provisions in 
42 CFR 422.111(a)(3) and 423.128(a)(3); Use: We require that Medicare 
Advantage (MA) organizations and Part D sponsors use standardized 
documents to satisfy disclosure requirements mandated by section 
1851(d)(3)(A) of the Social Security Act (Act) and 42 CFR 422.111(b) 
for MA organizations, and section 1860D-1(c) of the Act and 42 CFR 
423.128(a)(3) for Part D sponsors. The regulatory provisions require 
that MA organizations and Part D sponsors disclose plan information, 
including: Service area, benefits, access, grievance and appeals 
procedures, and quality improvement and quality assurance requirements 
by September 30th of each year. The MA organizations and Part D 
sponsors use the information to comply with the disclosure 
requirements. We will use the approved standardized documents to ensure 
that correct information is disclosed to current and potential 
enrollees.
    For 2017, CMS has a total of nine standardized ANOC/EOC documents: 
Health Maintenance Organization, Cost, Dual Eligible Special Needs, 
Medicare Medical Savings Account, Private-Fee-For-Service, Preferred 
Provider Organizations, Preferred Provider Organization with 
Prescription Drugs, Health Maintenance Organization with Prescription 
Drug, and Prescription Drug. These standardized documents will be used 
by MA organizations and Part D sponsors for the 2018 contract year.
    In revising the standardized ANOC/EOCs for contract year 2018, we 
did not add to or remove any section from the prior contract year ANOC/
EOC models. MA organizations and Part D sponsors are still required to 
use the standardized language in the ANOC/EOC models and to send this 
document to current members at least 15 days prior to the start of the 
annual enrollment period or by September 30, 2017 for the 2018 
enrollment season, based on 42 CFR 422.111(a) (3) and 423.128(a)(3). 
Form Number: CMS-10260 (OMB control number: 0938-1051); Frequency: 
Yearly; Affected Public: Private sector (Business or other for-
profits); Number of Respondents: 805; Total Annual Responses: 805; 
Total Annual Hours: 9,660. (For policy questions regarding this 
collection contact Gladys Valentin at 410-786-1620.)
    5. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: CAHPS Home Health 
Care Survey; Use: The national implementation of the Home Health Care 
Consumer Assessment of Healthcare Providers and Systems (CAHPS[supreg]) 
Survey is designed to collect ongoing data from samples of home health 
care patients who receive skilled services from Medicare-certified home 
health agencies. The data collected from the national implementation of 
the Home Health Care CAHPS Survey will be used for the following 
purposes: (1) To produce comparable data on the patients' perspectives 
of the care they receive from home health agencies, (2) to create 
incentives for agencies to improve the quality of care they provide 
through public reporting of survey results, and (3) to enhance public 
accountability in health care by increasing the transparency of the 
quality of care provided in return for the public investment. Sampling 
and data collection will be conducted on a monthly basis. Survey 
results will be analyzed and reported on a quarterly basis, with 
publicly reported results based on one year's worth of data.
    As part of this information collection request for the national 
implementation of Home Health Care CAHPS, CMS is also requesting 
approval to conduct a randomized mode experiment with a sample of home 
health agencies. The mode experiment compared the responses to the 
survey across the three proposed modes to determine whether adjustments 
are needed to ensure that the data collection mode does not influence 
the survey results. In addition, data from the mode experiment will be 
used to determine which, if any, patient characteristics may affect the 
patients' rating of the care they receive and, if so, develop an 
adjustment model of those data based on those factors. CMS worked with 
RTI, the federal contractor to recruit approximately 100 home health 
agencies to participate in the mode experiment. The mode experiment 
included approximately 23,000 home health care patients. Form Number: 
CMS-10275 (OMB control number: 0938-1066); Frequency: Quarterly; 
Affected Public: Individuals and households, Business or other for-
profit and Not-for-profit institutions; Number of Respondents: 
2,715,890; Total Annual Responses: 2,715,890; Total Annual Hours: 
699,440. (For policy questions regarding this collection contact Lori 
Teichman at 410-786-6684.)
    6. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medication 
Therapy Management Program Improvements; Use: Information collected by 
Part D medication therapy management programs (as required by the 
standardized format for the comprehensive medication review summary) 
will be used by beneficiaries or their authorized representatives, 
caregivers, and their healthcare providers to improve medication use 
and achieve better healthcare outcomes. Form Number: CMS-10396 (OMB 
control number 0938-1154); Frequency: Occasionally; Affected Public: 
Business or other for-profits; Number of Respondents: 599; Total Annual 
Responses: 1,211,661; Total Annual Hours: 807,451. (For policy 
questions regarding this collection contact Victoria Dang at 410-786-
3991.)
    7. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicaid 
Disproportionate Share Hospital (DSH) Annual Reporting Requirements; 
Use: States are required to submit an annual report that identifies 
each

[[Page 11224]]

disproportionate share hospital (DSH) that received a DSH payment under 
the state's Medicaid program in the preceding fiscal year and the 
amount of DSH payments paid to that hospital in the same year along 
with other information that the Secretary determines necessary to 
ensure the appropriateness of DSH payments; Form Number: CMS-R-266 (OMB 
control number: 0938-0746); Frequency: Yearly; Affected Public: State, 
Local, or Tribal Governments; Number of Respondents: 51; Total Annual 
Responses: 51; Total Annual Hours: 2,142. (For policy questions 
regarding this collection contact Robert Lane at 410-786-2015.)

    Dated: February 15, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2017-03369 Filed 2-17-17; 8:45 am]
 BILLING CODE 4120-01-P