Agency Information Collection Activities: Proposed Collection; Comment Request, 53474-53476 [2018-23027]
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53474
Federal Register / Vol. 83, No. 205 / Tuesday, October 23, 2018 / Notices
October 2010, notice is hereby given
that the Federal Accounting Standards
Advisory Board (FASAB) has released
for public comment an exposure draft of
a proposed Interpretation, Guidance on
Recognizing Liabilities Involving
Multiple Component Reporting Entities:
An Interpretation of SFFAS 5.
The proposed Interpretation is
available on the FASAB website at
https://www.fasab.gov/documents-forcomment/. Copies can be obtained by
contacting FASAB at (202) 512–7350.
Respondents are encouraged to
comment on any part of the exposure
draft and to provide the reasons for their
positions. Written comments are
requested by January 17, 2019, and
should be sent to fasab@fasab.gov or
Wendy M. Payne, Executive Director,
Federal Accounting Standards Advisory
Board, 441 G Street NW, Suite 1155,
Washington, DC 20548.
FOR FURTHER INFORMATION CONTACT: Ms.
Wendy M. Payne, Executive Director,
441 G Street NW, Suite 1155,
Washington, DC 20548, or call (202)
512–7350.
Authority: Federal Advisory Committee
Act, Pub. L. 92–463.
includes whether the acquisition of the
nonbanking company complies with the
standards in section 4 of the BHC Act
(12 U.S.C. 1843). Unless otherwise
noted, nonbanking activities will be
conducted throughout the United States.
Unless otherwise noted, comments
regarding each of these applications
must be received at the Reserve Bank
indicated or the offices of the Board of
Governors not later than November 20,
2018.
A. Federal Reserve Bank of Kansas
City (Dennis Denney, Assistant Vice
President) 1 Memorial Drive, Kansas
City, Missouri 64198–0001:
1. Foote Financial Shares, LLC,
Manhattan, Kansas; to become a bank
holding company by acquiring 100
percent of the voting shares of Peoples
State Bank, Manhattan, Kansas.
Board of Governors of the Federal Reserve
System, October 18, 2018.
Yao-Chin Chao,
Assistant Secretary of the Board.
[FR Doc. 2018–23099 Filed 10–22–18; 8:45 am]
BILLING CODE P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Dated: October 17, 2018.
Wendy M. Payne,
Executive Director.
Centers for Medicare & Medicaid
Services
[FR Doc. 2018–23110 Filed 10–22–18; 8:45 am]
BILLING CODE 1610–02–P
[Document Identifiers: CMS–224–14, CMS–
10684, CMS–10524, CMS–10572, CMS–
10433 and CMS–10657]
FEDERAL RESERVE SYSTEM
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Formations of, Acquisitions by, and
Mergers of Bank Holding Companies
The companies listed in this notice
have applied to the Board for approval,
pursuant to the Bank Holding Company
Act of 1956 (12 U.S.C. 1841 et seq.)
(BHC Act), Regulation Y (12 CFR part
225), and all other applicable statutes
and regulations to become a bank
holding company and/or to acquire the
assets or the ownership of, control of, or
the power to vote shares of a bank or
bank holding company and all of the
banks and nonbanking companies
owned by the bank holding company,
including the companies listed below.
The applications listed below, as well
as other related filings required by the
Board, are available for immediate
inspection at the Federal Reserve Bank
indicated. The applications will also be
available for inspection at the offices of
the Board of Governors. Interested
persons may express their views in
writing on the standards enumerated in
the BHC Act (12 U.S.C. 1842(c)). If the
proposal also involves the acquisition of
a nonbanking company, the review also
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Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, HHS.
ACTION: Notice.
AGENCY:
The Centers for Medicare &
Medicaid Services (CMS) is announcing
an opportunity for the public to
comment on CMS’ intention to collect
information from the public. Under the
Paperwork Reduction Act of 1995 (the
PRA), federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information (including each proposed
extension or reinstatement of an existing
collection of information) and to allow
60 days for public comment on the
proposed action. Interested persons are
invited to send comments regarding our
burden estimates or any other aspect of
this collection of information, including
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
SUMMARY:
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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
December 24, 2018.
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 ll, 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’ website address at
website address at https://www.cms.gov/
Regulations-and-Guidance/Legislation/
PaperworkReductionActof1995/PRAListing.html.
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:
William Parham 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–224–14 Federal Qualified Health
Center Cost Report
CMS–10684 21st Century Cures Act
Section 12002 IMD Study
CMS–10524 Medicare Program; Prior
Authorization Process for Certain
Durable Medical Equipment,
Prosthetic, Orthotics, and Supplies
(DMEPOS)
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CMS–10572 Transparency in Coverage
Reporting by Qualified Health Plan
Issuers
CMS–10433 Data Collection to
Support QHP Certification and
other Financial Management and
Exchange Operations
CMS–10657 The State Flexibility to
Stabilize the Market Grant Program
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. Title of Information Collection:
Federal Qualified Health Center Cost
Report; Type of Information Collection
Request: Extension of a currently
approved collection; Use: Under the
authority of sections 1815(a) and
1833(e) of the Act, CMS requires that
providers of services participating in the
Medicare program submit information
to determine costs for health care
services rendered to Medicare
beneficiaries. Furthermore, these
sections of the Act provide that no
Medicare payments will be made to a
provider unless it furnishes the
information. CMS requires that
providers follow reasonable cost
principles under 1861(v)(1)(A) of the
Act when completing the Medicare cost
report. Under the regulations at 42 CFR
413.20 and 413.24, CMS defines
adequate cost data and requires cost
reports from providers on an annual
basis. The Form CMS–224–14 cost
report is needed to determine a
provider’s reasonable cost incurred in
furnishing medical services to Medicare
beneficiaries and to calculate the FQHC
settlement amount. These providers,
paid under the FQHC prospective
payment system (PPS), may receive
reimbursement outside of the PPS for
Medicare reimbursable bad debts and
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pneumococcal and influenza vaccines.
The FQHC cost report is also used for
rate setting and payment refinement
activities, including developing a FQHC
market basket. Additionally, the
Medicare Payment Advisory
Commission (MedPAC) uses the FQHC
Medicare cost report data to calculate
Medicare margins, to formulate
recommendations to Congress regarding
the FQHC PPS, and to conduct
additional analysis of the FQHC PPS.
Form Number: CMS–224–14 (OMB
control number: 0938–1298); Frequency:
Yearly; Affected Public: State, Local, or
Tribal Governments; Number of
Respondents: 2,240; Number of
Responses: 2,240; Total Annual Hours:
129,920. (For questions regarding this
collection contact Julie Stankivic at
(410) 786–5725.)
2. Title of Information Collection: 21st
Century Cures Act Section 12002 IMD
Study; Type of Information Collection
Request: New collection (request for a
new OMB control number); Use: The
Act requires that HHS conduct a study
of the effects of the 2016 Medicaid
Managed Care final rule’s provisions
that clarified policy on coverage of IMD
services in lieu of other covered
services. The survey is needed to help
answer the 5 mandated study questions.
The collected data will be used by CMS
develop a Report to Congress as
required by the Act. Form Number:
CMS–10684 (OMB Control Number:
0938–TBD); Frequency: Yearly; Affected
Public: State, Local, or Tribal
Governments; Number of Respondents:
43; Number of Responses: 43; Total
Annual Hours: 86. (For questions
regarding this collection contact Laura
Snyder at (410) 786–3198.)
3. Title of Information Collection:
Medicare Program; Prior Authorization
Process for Certain Durable Medical
Equipment, Prosthetic, Orthotics, and
Supplies (DMEPOS); Type of
Information Collection Request:
Revision of a currently approved
collection; Use: The CMS has had
longstanding concerns about the
improper payments related to DMEPOS
items. The Department of Health and
Human Services’ Office of the Inspector
General and the U.S. Government
Accountability Office have published
multiple reports indicating questionable
billing practices by suppliers,
inappropriate Medicare payments, and
questionable utilization of DMEPOS
items. The fiscal year (FY) 2017
Medicare FFS program improper
payment rate for the Durable Medical
Equipment, Prosthetics, Orthotics, and
Supplies (DMEPOS) was 44.6%,
accounting for over $3.7 billion in
projected improper payments. The CMS
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53475
has implemented several initiatives in
recent years to address these issues,
such as the DMEPOS Competitive
Bidding Program, as well as heightened
screening of suppliers, as authorized by
the Affordable Care Act.
In addition to those actions, CMS is
continuing the use of prior
authorization in fee for service
Medicare. Prior authorization is a
process through which a request for
provisional affirmation of coverage is
submitted for review before an item is
rendered to a Medicare patient and
before a claim is submitted for payment.
Prior authorization helps make sure that
applicable Medicare coverage, payment,
and coding rules are met before item(s)
are rendered. Prior to furnishing the
item to the beneficiary and prior to
submitting the claim for processing, a
requester must submit a prior
authorization request that includes
evidence that the item complies with all
applicable Medicare coverage, coding,
and payment rules. Consistent with
§ 414.234(d), such evidence must
include the order, relevant information
from the beneficiary’s medical record,
and relevant supplier-produced
documentation. After receipt of all
applicable required Medicare
documentation, CMS or one of its
review contractors will conduct a
medical review and communicate a
decision that provisionally affirms or
non-affirms the request. A provisional
affirmative decision is a preliminary
finding that a future claim submitted to
Medicare for the DMEPOS item likely
meets Medicare’s coverage, coding, and
payment requirements. Suppliers who
receive a non-affirmative decision have
unlimited resubmission opportunities.
Form Number: CMS–10524 (OMB
control number: 0938–1293); Frequency:
Occasionally; Affected Public: Private
Sector (Business or other for-profits,
Not-for-Profit Institutions); Number of
Respondents: 321,551; Total Annual
Responses: 321,551; Total Annual
Hours: 160,775.68 (For policy questions
regarding this collection contact Yuliya
Cook at (410) 786–0157.)
4. Title of Information Collection:
Information Collection for Transparency
in Coverage Reporting by Qualified
Health Plan Issuers; Type of Information
Collection Request: Extension of a
currently approved information
collection request; Use: Section
1311(e)(3) of the Affordable Care Act
requires issuers of Qualified Health
Plans (QHPs), to make available and
submit transparency in coverage data.
This data collection would collect
certain information from QHP issuers in
Federally-facilitated Exchanges and
State-based Exchanges that rely on the
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federal IT platform (i.e.,
HealthCare.gov). HHS anticipates that
consumers may use this information to
inform plan selection.
As stated in the final rule Patient
Protection and Affordable Care Act;
Establishment of Exchanges and
Qualified Health Plans; Exchange
Standards for Employers (77 FR 18310;
March 27, 2012), broader
implementation will continue to be
addressed in separate rulemaking issued
by HHS, and the Departments of Labor
and the Treasury (the Departments).
Consistent with Public Health Service
Act (PHS Act) 1 section 2715A, which
largely extends the transparency
reporting provisions set forth in section
1311(e)(3) to non-grandfathered group
health plans (including large group and
self-insured health plans) and health
insurance issuers offering group and
individual health insurance coverage
(non-QHP issuers), the Departments
intend to propose other transparency
reporting requirements at a later time,
through a separate rulemaking
conducted by the Departments, for nonQHP issuers and non-grandfathered
group health plans. Those proposed
reporting requirements may differ from
those prescribed in the HHS proposal
under section 1311(e)(3), and will take
into account differences in markets,
reporting requirements already in
existence for non-QHPs (including
group health plans), and other relevant
factors. The Departments also intend to
streamline reporting under multiple
reporting provisions and reduce
unnecessary duplication. The
Departments intend to implement any
transparency reporting requirements
applicable to non-QHP issuers and nongrandfathered group health plans only
after notice and comment, and after
giving those issuers and plans sufficient
time, following the publication of final
rules, to come into compliance with
those requirements. Form Number:
CMS–10572 (OMB control number:
0938–1310); Frequency: Annually;
Affected Public: Private Sector (Business
or other for-profits); Number of
Respondents: 160; Number of
Responses: 160; Total Annual Hours:
10,880. (For questions regarding this
collection contact Valisha Jackson at
(301) 492–5145.)
5. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Data Collection
to Support QHP Certification and other
1 PHS Act section 2715A also is incorporated into
section 715(a)(1) of the Employee Retirement
Income Security Act and section 9815(a)(1) of the
Internal Revenue Code.
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Jkt 247001
Financial Management and Exchange
Operations; Use: As directed by the rule
Establishment of Exchanges and
Qualified Health Plans; Exchange
Standards for Employers (77 FR 18310)
(Exchange rule), each Exchange is
responsible for the certification and
offering of Qualified Health Plans
(QHPs). To offer insurance through an
Exchange, a health insurance issuer
must have its health plans certified as
QHPs by the Exchange. A QHP must
meet certain minimum certification
standards, such as network adequacy,
inclusion of Essential Community
Providers (ECPs), and nondiscrimination. The Exchange is
responsible for ensuring that QHPs meet
these minimum certification standards
as described in the Exchange rule under
45 CFR 155 and 156, based on the
Patient Protection and Affordable Care
Act (PPACA), as well as other standards
determined by the Exchange. Issuers can
offer individual and small group market
plans outside of the Exchanges that are
not QHPs.
The instruments in this information
collection will be used for the 2020
certification process and beyond.
Providing these instruments now will
give issuers and other stakeholders more
opportunity to familiarize themselves
with the instruments before releasing
the 2020 application. Form Number:
CMS–10433 (OMB control number:
0938–1187); Frequency: Annually;
Affected Public: State, Local, or Tribal
Governments, Private Sector (Business
or other for-profits); Number of
Respondents: 2,892 Number of
Responses: 2,892; Total Annual Hours:
68,666. (For questions regarding this
collection contact Joshua Annas at (301)
492–4407).
6. Type of Information Collection
Request: Request for a new OMB control
number; Title of Information Collection:
The State Flexibility to Stabilize the
Market Grant Program Reporting; Use:
Section 1003 of the Affordable Care Act
(ACA) adds a new section 2794 to the
PHS Act entitled, ‘‘Ensuring That
Consumers Get Value for Their Dollars.’’
Specifically, section 2794(a) requires the
Secretary of the Department of Health
and Human Services (the Secretary)
(HHS), in conjunction with the States, to
establish a process for the annual review
of health insurance premiums to protect
consumers from unreasonable rate
increases. Section 2794(c) directs the
Secretary to carry out a program to
award grants to States. Section
2794(c)(2)(B) specifies that any
appropriated Rate Review Grant funds
that are not fully obligated by the end
of FY 2014 shall remain available to the
Secretary for grants to States for
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planning and implementing the
insurance market reforms and consumer
protections under Part A of title XXVII
of the Public Health Service Act (PHS
Act). States that are awarded funds
under this funding opportunity are
required to provide CMS with four
quarterly reports and one annual report
(except for the last year of the grant)
until the end of the grant period
detailing the state’s progression towards
planning and/or implementing the preselected market reforms under Part A of
Title XXVII of the PHS Act. A final
report is due at the end of the grant
period. Form Number: CMS–10657
(OMB control number: 0938–NEW);
Frequency: Annually and Quarterly;
Affected Public: State, Local or Tribal
Governments; Number of Respondents:
31; Total Annual Responses: 5; Total
Annual Hours: 2,108. (For policy
questions regarding this collection
contact Jim Taing at (301) 492–4182.)
Dated: October 17, 2018.
William N. Parham, III,
Director, Paperwork Reduction Staff. Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2018–23027 Filed 10–22–18; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket Nos. FDA–2017–E–5940, FDA–
2017–E–5941, FDA–2017–E–5943, and FDA–
2017–E–5944]
Determination of Regulatory Review
Period for Purposes of Patent
Extension; SILIQ
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
The Food and Drug
Administration (FDA or the Agency) has
determined the regulatory review period
for SILIQ and is publishing this notice
of that determination as required by
law. FDA has made the determination
because of the submission of
applications 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 December 24, 2018.
Furthermore, any interested person may
petition FDA for a determination
SUMMARY:
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Agencies
[Federal Register Volume 83, Number 205 (Tuesday, October 23, 2018)]
[Notices]
[Pages 53474-53476]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-23027]
=======================================================================
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-224-14, CMS-10684, CMS-10524, CMS-10572,
CMS-10433 and CMS-10657]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is
announcing an opportunity for the public to comment on CMS' intention
to collect information from the public. Under the Paperwork Reduction
Act of 1995 (the PRA), federal agencies are required to publish notice
in the Federal Register concerning each proposed collection of
information (including each proposed extension or reinstatement of an
existing collection of information) and to allow 60 days for public
comment on the proposed action. Interested persons are invited to send
comments regarding our burden estimates or any other aspect of this
collection of information, including 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 December 24, 2018.
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' website address at website address at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
2. Email your request, including your address, phone number, OMB
number, and CMS document identifier, to [email protected].
3. Call the Reports Clearance Office at (410) 786-1326.
FOR FURTHER INFORMATION CONTACT: William Parham 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-224-14 Federal Qualified Health Center Cost Report
CMS-10684 21st Century Cures Act Section 12002 IMD Study
CMS-10524 Medicare Program; Prior Authorization Process for Certain
Durable Medical Equipment, Prosthetic, Orthotics, and Supplies (DMEPOS)
[[Page 53475]]
CMS-10572 Transparency in Coverage Reporting by Qualified Health Plan
Issuers
CMS-10433 Data Collection to Support QHP Certification and other
Financial Management and Exchange Operations
CMS-10657 The State Flexibility to Stabilize the Market Grant Program
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. Title of Information Collection: Federal Qualified Health Center
Cost Report; Type of Information Collection Request: Extension of a
currently approved collection; Use: Under the authority of sections
1815(a) and 1833(e) of the Act, CMS requires that providers of services
participating in the Medicare program submit information to determine
costs for health care services rendered to Medicare beneficiaries.
Furthermore, these sections of the Act provide that no Medicare
payments will be made to a provider unless it furnishes the
information. CMS requires that providers follow reasonable cost
principles under 1861(v)(1)(A) of the Act when completing the Medicare
cost report. Under the regulations at 42 CFR 413.20 and 413.24, CMS
defines adequate cost data and requires cost reports from providers on
an annual basis. The Form CMS-224-14 cost report is needed to determine
a provider's reasonable cost incurred in furnishing medical services to
Medicare beneficiaries and to calculate the FQHC settlement amount.
These providers, paid under the FQHC prospective payment system (PPS),
may receive reimbursement outside of the PPS for Medicare reimbursable
bad debts and pneumococcal and influenza vaccines. The FQHC cost report
is also used for rate setting and payment refinement activities,
including developing a FQHC market basket. Additionally, the Medicare
Payment Advisory Commission (MedPAC) uses the FQHC Medicare cost report
data to calculate Medicare margins, to formulate recommendations to
Congress regarding the FQHC PPS, and to conduct additional analysis of
the FQHC PPS. Form Number: CMS-224-14 (OMB control number: 0938-1298);
Frequency: Yearly; Affected Public: State, Local, or Tribal
Governments; Number of Respondents: 2,240; Number of Responses: 2,240;
Total Annual Hours: 129,920. (For questions regarding this collection
contact Julie Stankivic at (410) 786-5725.)
2. Title of Information Collection: 21st Century Cures Act Section
12002 IMD Study; Type of Information Collection Request: New collection
(request for a new OMB control number); Use: The Act requires that HHS
conduct a study of the effects of the 2016 Medicaid Managed Care final
rule's provisions that clarified policy on coverage of IMD services in
lieu of other covered services. The survey is needed to help answer the
5 mandated study questions. The collected data will be used by CMS
develop a Report to Congress as required by the Act. Form Number: CMS-
10684 (OMB Control Number: 0938-TBD); Frequency: Yearly; Affected
Public: State, Local, or Tribal Governments; Number of Respondents: 43;
Number of Responses: 43; Total Annual Hours: 86. (For questions
regarding this collection contact Laura Snyder at (410) 786-3198.)
3. Title of Information Collection: Medicare Program; Prior
Authorization Process for Certain Durable Medical Equipment,
Prosthetic, Orthotics, and Supplies (DMEPOS); Type of Information
Collection Request: Revision of a currently approved collection; Use:
The CMS has had longstanding concerns about the improper payments
related to DMEPOS items. The Department of Health and Human Services'
Office of the Inspector General and the U.S. Government Accountability
Office have published multiple reports indicating questionable billing
practices by suppliers, inappropriate Medicare payments, and
questionable utilization of DMEPOS items. The fiscal year (FY) 2017
Medicare FFS program improper payment rate for the Durable Medical
Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) was 44.6%,
accounting for over $3.7 billion in projected improper payments. The
CMS has implemented several initiatives in recent years to address
these issues, such as the DMEPOS Competitive Bidding Program, as well
as heightened screening of suppliers, as authorized by the Affordable
Care Act.
In addition to those actions, CMS is continuing the use of prior
authorization in fee for service Medicare. Prior authorization is a
process through which a request for provisional affirmation of coverage
is submitted for review before an item is rendered to a Medicare
patient and before a claim is submitted for payment. Prior
authorization helps make sure that applicable Medicare coverage,
payment, and coding rules are met before item(s) are rendered. Prior to
furnishing the item to the beneficiary and prior to submitting the
claim for processing, a requester must submit a prior authorization
request that includes evidence that the item complies with all
applicable Medicare coverage, coding, and payment rules. Consistent
with Sec. [thinsp]414.234(d), such evidence must include the order,
relevant information from the beneficiary's medical record, and
relevant supplier-produced documentation. After receipt of all
applicable required Medicare documentation, CMS or one of its review
contractors will conduct a medical review and communicate a decision
that provisionally affirms or non-affirms the request. A provisional
affirmative decision is a preliminary finding that a future claim
submitted to Medicare for the DMEPOS item likely meets Medicare's
coverage, coding, and payment requirements. Suppliers who receive a
non-affirmative decision have unlimited resubmission opportunities.
Form Number: CMS-10524 (OMB control number: 0938-1293); Frequency:
Occasionally; Affected Public: Private Sector (Business or other for-
profits, Not-for-Profit Institutions); Number of Respondents: 321,551;
Total Annual Responses: 321,551; Total Annual Hours: 160,775.68 (For
policy questions regarding this collection contact Yuliya Cook at (410)
786-0157.)
4. Title of Information Collection: Information Collection for
Transparency in Coverage Reporting by Qualified Health Plan Issuers;
Type of Information Collection Request: Extension of a currently
approved information collection request; Use: Section 1311(e)(3) of the
Affordable Care Act requires issuers of Qualified Health Plans (QHPs),
to make available and submit transparency in coverage data. This data
collection would collect certain information from QHP issuers in
Federally-facilitated Exchanges and State-based Exchanges that rely on
the
[[Page 53476]]
federal IT platform (i.e., HealthCare.gov). HHS anticipates that
consumers may use this information to inform plan selection.
As stated in the final rule Patient Protection and Affordable Care
Act; Establishment of Exchanges and Qualified Health Plans; Exchange
Standards for Employers (77 FR 18310; March 27, 2012), broader
implementation will continue to be addressed in separate rulemaking
issued by HHS, and the Departments of Labor and the Treasury (the
Departments).
Consistent with Public Health Service Act (PHS Act) \1\ section
2715A, which largely extends the transparency reporting provisions set
forth in section 1311(e)(3) to non-grandfathered group health plans
(including large group and self-insured health plans) and health
insurance issuers offering group and individual health insurance
coverage (non-QHP issuers), the Departments intend to propose other
transparency reporting requirements at a later time, through a separate
rulemaking conducted by the Departments, for non-QHP issuers and non-
grandfathered group health plans. Those proposed reporting requirements
may differ from those prescribed in the HHS proposal under section
1311(e)(3), and will take into account differences in markets,
reporting requirements already in existence for non-QHPs (including
group health plans), and other relevant factors. The Departments also
intend to streamline reporting under multiple reporting provisions and
reduce unnecessary duplication. The Departments intend to implement any
transparency reporting requirements applicable to non-QHP issuers and
non-grandfathered group health plans only after notice and comment, and
after giving those issuers and plans sufficient time, following the
publication of final rules, to come into compliance with those
requirements. Form Number: CMS-10572 (OMB control number: 0938-1310);
Frequency: Annually; Affected Public: Private Sector (Business or other
for-profits); Number of Respondents: 160; Number of Responses: 160;
Total Annual Hours: 10,880. (For questions regarding this collection
contact Valisha Jackson at (301) 492-5145.)
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\1\ PHS Act section 2715A also is incorporated into section
715(a)(1) of the Employee Retirement Income Security Act and section
9815(a)(1) of the Internal Revenue Code.
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5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Data Collection
to Support QHP Certification and other Financial Management and
Exchange Operations; Use: As directed by the rule Establishment of
Exchanges and Qualified Health Plans; Exchange Standards for Employers
(77 FR 18310) (Exchange rule), each Exchange is responsible for the
certification and offering of Qualified Health Plans (QHPs). To offer
insurance through an Exchange, a health insurance issuer must have its
health plans certified as QHPs by the Exchange. A QHP must meet certain
minimum certification standards, such as network adequacy, inclusion of
Essential Community Providers (ECPs), and non-discrimination. The
Exchange is responsible for ensuring that QHPs meet these minimum
certification standards as described in the Exchange rule under 45 CFR
155 and 156, based on the Patient Protection and Affordable Care Act
(PPACA), as well as other standards determined by the Exchange. Issuers
can offer individual and small group market plans outside of the
Exchanges that are not QHPs.
The instruments in this information collection will be used for the
2020 certification process and beyond. Providing these instruments now
will give issuers and other stakeholders more opportunity to
familiarize themselves with the instruments before releasing the 2020
application. Form Number: CMS-10433 (OMB control number: 0938-1187);
Frequency: Annually; Affected Public: State, Local, or Tribal
Governments, Private Sector (Business or other for-profits); Number of
Respondents: 2,892 Number of Responses: 2,892; Total Annual Hours:
68,666. (For questions regarding this collection contact Joshua Annas
at (301) 492-4407).
6. Type of Information Collection Request: Request for a new OMB
control number; Title of Information Collection: The State Flexibility
to Stabilize the Market Grant Program Reporting; Use: Section 1003 of
the Affordable Care Act (ACA) adds a new section 2794 to the PHS Act
entitled, ``Ensuring That Consumers Get Value for Their Dollars.''
Specifically, section 2794(a) requires the Secretary of the Department
of Health and Human Services (the Secretary) (HHS), in conjunction with
the States, to establish a process for the annual review of health
insurance premiums to protect consumers from unreasonable rate
increases. Section 2794(c) directs the Secretary to carry out a program
to award grants to States. Section 2794(c)(2)(B) specifies that any
appropriated Rate Review Grant funds that are not fully obligated by
the end of FY 2014 shall remain available to the Secretary for grants
to States for planning and implementing the insurance market reforms
and consumer protections under Part A of title XXVII of the Public
Health Service Act (PHS Act). States that are awarded funds under this
funding opportunity are required to provide CMS with four quarterly
reports and one annual report (except for the last year of the grant)
until the end of the grant period detailing the state's progression
towards planning and/or implementing the pre-selected market reforms
under Part A of Title XXVII of the PHS Act. A final report is due at
the end of the grant period. Form Number: CMS-10657 (OMB control
number: 0938-NEW); Frequency: Annually and Quarterly; Affected Public:
State, Local or Tribal Governments; Number of Respondents: 31; Total
Annual Responses: 5; Total Annual Hours: 2,108. (For policy questions
regarding this collection contact Jim Taing at (301) 492-4182.)
Dated: October 17, 2018.
William N. Parham, III,
Director, Paperwork Reduction Staff. Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2018-23027 Filed 10-22-18; 8:45 am]
BILLING CODE 4120-01-P