Agency Information Collection Activities: Submission for OMB Review; Comment Request, 12303-12305 [2020-04242]
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Federal Register / Vol. 85, No. 41 / Monday, March 2, 2020 / Notices
deteriorated, (4) significant steel
corrosion, (5) bridge capacity is
insufficient, and (6) deficiencies
prompting the bridge posting on
October 27, 2017, from 50 tons to 5 tons.
A Final Environmental Impact
Statement (FEIS) and ROD were
published in January 2007, which
addressed the construction of a new
Madawaska LPOE.
Built in 1959, the current LPOE
suffers from facility, operational, and
site deficiencies, and does not meet
current CBP mission and operational
requirements for a LPOE. A few noted
deficiencies: (1) Lack of office and
inspection areas, (2) deficient inbound
and outbound passenger and
commercial processing areas, (3)
inadequate queuing space for vehicles,
and (4) inability to meet the
Architectural Barriers Act. In
furtherance of the LPOE Project, GSA
previously acquired approximately nine
acres of land but did not commence
construction.
A Supplemental Environmental
Impact Statement (SEIS) was needed
due to a change in circumstance: The
decision by MaineDOT and New
Brunswick Department of
Transportation and Infrastructure
(NBDTI) to include alternatives for
addressing deficiencies to the existing
Madawaska—Edmundston International
Bridge. The SEIS addresses changes to
the Proposed Action, including an
updated design in accordance with
current GSA and CBP requirements, a
new International Bridge, and
additional land acquisition.
A Final Supplemental Environmental
Impact Statement (FSEIS)/Final
Programmatic Section 4(f) Evaluation
were issued for public review and
comment on October 4, 2019. The FSEIS
identified the Preferred Alternative for
the new U.S. LPOE and new
International Bridge location and
design; described the environmental
impacts of the proposed project and
proposed mitigation; and addressed
comments received on the Draft
Supplemental Environmental Impact
Statement/Draft Programmatic Section
4(f) Evaluation issued on November 26,
2018. The 30-day comment period for
the FSEIS/Final Programmatic Section
4(f) ended on November 4, 2019.
The ROD states what the decision is;
identifies the alternatives considered,
including the environmentally preferred
alternative; and discusses mitigation
plans, including enforcement and
monitoring commitments. In the ROD,
the agencies discuss all the factors that
were contemplated when reaching their
decision on whether to, and if so how
to, proceed with the Proposed Action.
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The ROD discusses all practical means
to avoid or minimize environmental
harm that have been adopted.
The GSA considered three build
alternatives for the LPOE FSEIS/Final
Programmatic Section 4(f) Evaluation;
the FHWA and MaineDOT considered
three build alternatives for the
International Bridge. The Selected
Alternative is identified as LPOE
Alternative C and Bridge Alternative 2
from the FSEIS/Final Programmatic
Section 4(f) Evaluation. LPOE
Alternative C and Bridge Alternative 2
are the environmentally preferred
alternatives for the LPOE and
International Bridge, respectively.
LPOE Alternative C was identified as
the Preferred LPOE Alternative because
it furthers the purpose of the project and
satisfies the needs for the project. The
Preferred LPOE Alternative: (1) Provides
enough space for safe and efficient flow
of traffic through the LPOE; (2) provides
enough space for the operations of the
LPOE to function efficiently; (3) meets
MaineDOT’s access management
guidelines and the entrance and exit to
the LPOE would be approved by
MaineDOT; (4) provides a safer location
and distance between the outbound and
inbound driveways; (5) provides enough
open space to accommodate the
necessary length of road to descend
from the bridge landing elevation (538)
to the elevation of Mill Street (520)
without a steep road grade, and
provides safer maintenance and
circulation in winter conditions; (6)
provides increased line of sight, safety
and security for CBP personnel to carry
out their mission and operations; (7)
allows inbound and outbound
driveways to connect to Mill Street,
eliminating the need for B-trains to use
Main Street; and, (8) provides enough
space for seasonal snow storage and
future expansion.
Bridge Alternative 2 was identified as
the Preferred Bridge Alternative
because, although it would have one
more pier in the Saint John River than
another alternative considered, the piers
to support the bridge would be smaller,
decreasing the risks for ice jamming in
the river. While Bridge Alternative 2
would have similar construction
impacts and comparable costs (both
construction and long-term operation
and maintenance) to other alternatives,
Bridge Alternative 2 would take
approximately six months less time to
construct.
The FSEIS/Final Programmatic
Section 4(f) Evaluation includes a
comprehensive summary of the
mitigation measures and commitments
from the GSA, FHWA, and MaineDOT
in support of the development of the
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Preferred LPOE Alternative and the
Preferred Bridge Alternative to further
avoid and minimize adverse impacts.
Dated: February 11, 2020.
Glenn Rotondo,
Regional Commissioner, Public Buildings
Service.
[FR Doc. 2020–04252 Filed 2–28–20; 8:45 am]
BILLING CODE 6820–FP–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier CMS–10146, CMS–
10062, CMS–10242 and CMS–685]
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
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 April 1, 2020.
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
SUMMARY:
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Federal Register / Vol. 85, No. 41 / Monday, March 2, 2020 / Notices
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’ website address at
website address at https://www.cms.gov/
Regulations-and-Guidance/Legislation/
PaperworkReductionActof1995/PRAListing.html.
1. Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov.
2. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
William Parham at (410) 786–4669.
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 with change of a
currently approved collection; Title of
Information Collection: Notice of Denial
of Medicare Prescription Drug Coverage;
Use: The purpose of this notice is to
provide information to enrollees when
prescription drug coverage has been
denied, in whole or in part, by their Part
D plans. The notice must be readable,
understandable, and state the specific
reasons for the denial. The notice must
also remind enrollees about their rights
and protections related to requests for
prescription drug coverage and include
an explanation of both the standard and
expedited redetermination processes
and the rest of the appeal process.
CMS requests approval of changes to
a currently approved collection under
section 1860D–4(g)(1) of the Social
Security Act which requires Part D plan
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sponsors that deny prescription drug
coverage to provide a written notice of
the denial to the enrollee. The written
notice must include a statement, in
understandable language, of the reasons
for the denial and a description of the
appeals process.
Medicare beneficiaries who are
enrolled in a Part D plan will be
informed of adverse decisions related to
their prescription drug coverage and
their right to appeal these decisions.
The notice provides all ways that the
beneficiary can file an appeal under one
section. The Part D instructions have
also been revised to include a paragraph
informing providers that in the case that
a request for a coverage determination is
denied under Part B due to step therapy
requirements, a different notice should
be given.
This denial notice is primarily issued
to Part D plan enrollees (Medicare
beneficiaries) and is most commonly
sent to enrollees by mail. Relying on
electronic transmission of this notice to
beneficiaries is impractical. Plans are
required by regulation to maintain a
website by which beneficiaries can
request an appeal. In this version of the
notice, website information is more
prominently displayed. Form Number:
CMS–10146 (OMB control number:
0938–0976); Frequency: Yearly; Affected
Public: State, Local, or Tribal
Governments; Number of Respondents:
525; Total Annual Responses:
2,887,866; Total Annual Hours: 721,967.
(For policy questions regarding this
collection contact Sara Klotz at (410)
786–1984.)
2. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Collection of
Diagnostic Data in the Abbreviated
RAPS Format from Medicare Advantage
Organizations for Risk Adjusted
Payments; Use: The 1997 BBA and later
legislation required CMS to adjust perbeneficiary payments with a risk
adjustment methodology using
diagnoses to measure relative risk due to
health status instead of just
demographic characteristics such as age,
sex, and Medicaid eligibility. The
purpose of risk adjustment is to pay
plan sponsors accurately based on the
health status and diagnoses of their
Medicare enrollees. Risk adjustment
using diagnoses provides more accurate
payments for Medicare Advantage
Organizations (MAO), with higher
payments for enrollees at risk for being
sicker, and lower payments for enrollees
predicted to be healthier.
The BBA constituted the first
legislative mandate for health status risk
adjustment. Section 1853 (a)(3) of the
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Social Security Act as enacted by
Section 4001 of Subtitle A of the BBA
required the Secretary to implement a
risk adjustment methodology that
accounted for variations in per capita
costs based on health status and other
demographic factors for payment to
Medicare+Choice (now MA)
organizations. The new methodology
was to be effective no later than January
1, 2000. The BBA also required that
M+C organizations submit data for use
in developing risk adjusted payments.
Risk adjustment allows CMS to pay
plans for the health risk of the
beneficiaries they enroll, instead of
paying an identical an average amount
for each enrollee Medicare beneficiaries.
By risk adjusting plan payments, CMS is
able to make appropriate and accurate
payments for enrollees with differences
in expected costs. Risk adjustment is
used to adjust bidding and payment
based on the health status and
demographic characteristics of an
enrollee. Risk scores measure individual
beneficiaries’ relative risk and the risk
scores are used to adjust payments for
each beneficiary’s expected
expenditures. By risk adjusting plan
bids, CMS is able to also use
standardized bids as base payments to
plans.
CMS’ fundamental goal for the
abbreviate format RAPS data is to
require collection of the minimum data
necessary for accurate risk-adjusted
payment. We believe that diagnostic
data provide the most reliable approach
to measuring health status, as required
by statute. In the absence of these data,
we would not be able to accurately
determine the beneficiary’s health (risk)
status. Form Number: CMS–10062
(OMB control number: 0938–0878);
Frequency: Yearly; Affected Public:
State, Local, or Tribal Governments;
Number of Respondents: 761; Total
Annual Responses: 46,610,448; Total
Annual Hours: 33,484. (For policy
questions regarding this collection
contact Michael P Massimini at 410–
786–1566.)
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Emergency and
Non-Emergency Ambulance Transports
and Beneficiary Signature
Requirements; Use: The statutory
authority requiring a beneficiary’s
signature on a claim submitted by a
provider is located in section 1835(a)
and in 1814(a) of the Social Security Act
(the Act), for Part B and Part A services,
respectively. The authority requiring a
beneficiary’s signature for supplier
claims is implicit in sections
1842(b)(3)(B) (ii) and in 1848(g)(4) of the
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khammond on DSKJM1Z7X2PROD with NOTICES
Federal Register / Vol. 85, No. 41 / Monday, March 2, 2020 / Notices
Act. Federal regulations at 42 CFR
424.32(a)(3) state that all claims must be
signed by the beneficiary or on behalf of
the Beneficiary (in accordance with
424.36). Section 424.36(a) states that the
beneficiary’s signature is required on a
claim unless the beneficiary has died or
the provisions of 424.36(b), (c), or (d)
apply. For emergency and
nonemergency ambulance transport
services, where the beneficiary is
physically or mentally incapable of
signing the claim (and the beneficiary’s
authorized representative is unavailable
or unwilling to sign the claim), that it
is impractical and infeasible to require
an ambulance provider or supplier to
later locate the beneficiary or the person
authorized to sign on behalf of the
beneficiary, before submitting the claim
to Medicare for payment. Therefore, an
exception was created to the beneficiary
signature requirement with respect to
emergency and nonemergency
ambulance transport services, where the
beneficiary is physically or mentally
incapable of signing the claim, and if
certain documentation requirements are
met. Thus, we added subsection (6) to
paragraph (b) of 42 CFR 424.36. The
information required in this ICR is
needed to help ensure that services were
in fact rendered and were rendered as
billed. Form Number: CMS–10242(OMB
control number: 0938–1049); Frequency:
Yearly; Affected Public: Private Sector;
Business or other for-profits, Not-forprofit Institutions; Number of
Respondents: 10,229; Total Annual
Responses: 13,318,440; Total Annual
Hours: 1,110,757. (For policy questions
regarding this collection contact Martha
Kuespert at (410) 786–4605.)
4. Type of Information Collection
Request: Revision of a previously
approved collection; Title of
Information Collection: End Stage Renal
Disease (ESRD) Network Semi-Annual
Cost Report Forms and Supporting
Regulations; Use: Section 1881(c) of the
Social Security Act establishes End
Stage Renal Disease (ESRD) Network
contracts. The regulations found at 42
CFR 405.2110 and 405.2112 designated
18 ESRD Networks which are funded by
renewable contracts. These contracts are
on 3-year cycles. To better administer
the program, CMS is requiring
contractors to submit semi-annual cost
reports. The purpose of the cost reports
is to enable the ESRD Networks to
report costs in a standardized manner.
This will allow CMS to review, compare
and project ESRD Network costs during
the life of the contract. Form Number:
CMS–685 (OMB Control Number: 0938–
0657); Frequency: Reporting—Semiannually; Affected Public: Not-for-profit
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Jkt 250001
institutions; Number of Respondents:
18; Total Annual Responses: 36; Total
Annual Hours: 108. (For policy
questions regarding this collection
contact Benjamin Bernstein at 410–786–
6570).
Dated: February 26, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2020–04242 Filed 2–28–20; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10589]
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
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
May 1, 2020.
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
SUMMARY:
PO 00000
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12305
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 lllll, 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 N. Parham at (410) 786–4669.
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–10589 QECP Annual Report
Workbook Submission Requirement for
Qualified Entities Under ACA Section
10332
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.
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]]>Agencies
[Federal Register Volume 85, Number 41 (Monday, March 2, 2020)]
[Notices]
[Pages 12303-12305]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-04242]
=======================================================================
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier CMS-10146, CMS-10062, CMS-10242 and CMS-685]
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 April 1, 2020.
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
[[Page 12304]]
Number: (202) 395-5806 OR, Email: [email protected].
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.
1. Email your request, including your address, phone number, OMB
number, and CMS document identifier, to [email protected].
2. Call the Reports Clearance Office at (410) 786-1326.
FOR FURTHER INFORMATION CONTACT: William Parham at (410) 786-4669.
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 with change of
a currently approved collection; Title of Information Collection:
Notice of Denial of Medicare Prescription Drug Coverage; Use: The
purpose of this notice is to provide information to enrollees when
prescription drug coverage has been denied, in whole or in part, by
their Part D plans. The notice must be readable, understandable, and
state the specific reasons for the denial. The notice must also remind
enrollees about their rights and protections related to requests for
prescription drug coverage and include an explanation of both the
standard and expedited redetermination processes and the rest of the
appeal process.
CMS requests approval of changes to a currently approved collection
under section 1860D-4(g)(1) of the Social Security Act which requires
Part D plan sponsors that deny prescription drug coverage to provide a
written notice of the denial to the enrollee. The written notice must
include a statement, in understandable language, of the reasons for the
denial and a description of the appeals process.
Medicare beneficiaries who are enrolled in a Part D plan will be
informed of adverse decisions related to their prescription drug
coverage and their right to appeal these decisions. The notice provides
all ways that the beneficiary can file an appeal under one section. The
Part D instructions have also been revised to include a paragraph
informing providers that in the case that a request for a coverage
determination is denied under Part B due to step therapy requirements,
a different notice should be given.
This denial notice is primarily issued to Part D plan enrollees
(Medicare beneficiaries) and is most commonly sent to enrollees by
mail. Relying on electronic transmission of this notice to
beneficiaries is impractical. Plans are required by regulation to
maintain a website by which beneficiaries can request an appeal. In
this version of the notice, website information is more prominently
displayed. Form Number: CMS-10146 (OMB control number: 0938-0976);
Frequency: Yearly; Affected Public: State, Local, or Tribal
Governments; Number of Respondents: 525; Total Annual Responses:
2,887,866; Total Annual Hours: 721,967. (For policy questions regarding
this collection contact Sara Klotz at (410) 786-1984.)
2. Type of Information Collection Request: Extension without change
of a currently approved collection; Title of Information Collection:
Collection of Diagnostic Data in the Abbreviated RAPS Format from
Medicare Advantage Organizations for Risk Adjusted Payments; Use: The
1997 BBA and later legislation required CMS to adjust per-beneficiary
payments with a risk adjustment methodology using diagnoses to measure
relative risk due to health status instead of just demographic
characteristics such as age, sex, and Medicaid eligibility. The purpose
of risk adjustment is to pay plan sponsors accurately based on the
health status and diagnoses of their Medicare enrollees. Risk
adjustment using diagnoses provides more accurate payments for Medicare
Advantage Organizations (MAO), with higher payments for enrollees at
risk for being sicker, and lower payments for enrollees predicted to be
healthier.
The BBA constituted the first legislative mandate for health status
risk adjustment. Section 1853 (a)(3) of the Social Security Act as
enacted by Section 4001 of Subtitle A of the BBA required the Secretary
to implement a risk adjustment methodology that accounted for
variations in per capita costs based on health status and other
demographic factors for payment to Medicare+Choice (now MA)
organizations. The new methodology was to be effective no later than
January 1, 2000. The BBA also required that M+C organizations submit
data for use in developing risk adjusted payments.
Risk adjustment allows CMS to pay plans for the health risk of the
beneficiaries they enroll, instead of paying an identical an average
amount for each enrollee Medicare beneficiaries. By risk adjusting plan
payments, CMS is able to make appropriate and accurate payments for
enrollees with differences in expected costs. Risk adjustment is used
to adjust bidding and payment based on the health status and
demographic characteristics of an enrollee. Risk scores measure
individual beneficiaries' relative risk and the risk scores are used to
adjust payments for each beneficiary's expected expenditures. By risk
adjusting plan bids, CMS is able to also use standardized bids as base
payments to plans.
CMS' fundamental goal for the abbreviate format RAPS data is to
require collection of the minimum data necessary for accurate risk-
adjusted payment. We believe that diagnostic data provide the most
reliable approach to measuring health status, as required by statute.
In the absence of these data, we would not be able to accurately
determine the beneficiary's health (risk) status. Form Number: CMS-
10062 (OMB control number: 0938-0878); Frequency: Yearly; Affected
Public: State, Local, or Tribal Governments; Number of Respondents:
761; Total Annual Responses: 46,610,448; Total Annual Hours: 33,484.
(For policy questions regarding this collection contact Michael P
Massimini at 410-786-1566.)
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Emergency and
Non-Emergency Ambulance Transports and Beneficiary Signature
Requirements; Use: The statutory authority requiring a beneficiary's
signature on a claim submitted by a provider is located in section
1835(a) and in 1814(a) of the Social Security Act (the Act), for Part B
and Part A services, respectively. The authority requiring a
beneficiary's signature for supplier claims is implicit in sections
1842(b)(3)(B) (ii) and in 1848(g)(4) of the
[[Page 12305]]
Act. Federal regulations at 42 CFR 424.32(a)(3) state that all claims
must be signed by the beneficiary or on behalf of the Beneficiary (in
accordance with 424.36). Section 424.36(a) states that the
beneficiary's signature is required on a claim unless the beneficiary
has died or the provisions of 424.36(b), (c), or (d) apply. For
emergency and nonemergency ambulance transport services, where the
beneficiary is physically or mentally incapable of signing the claim
(and the beneficiary's authorized representative is unavailable or
unwilling to sign the claim), that it is impractical and infeasible to
require an ambulance provider or supplier to later locate the
beneficiary or the person authorized to sign on behalf of the
beneficiary, before submitting the claim to Medicare for payment.
Therefore, an exception was created to the beneficiary signature
requirement with respect to emergency and nonemergency ambulance
transport services, where the beneficiary is physically or mentally
incapable of signing the claim, and if certain documentation
requirements are met. Thus, we added subsection (6) to paragraph (b) of
42 CFR 424.36. The information required in this ICR is needed to help
ensure that services were in fact rendered and were rendered as billed.
Form Number: CMS-10242(OMB control number: 0938-1049); Frequency:
Yearly; Affected Public: Private Sector; Business or other for-profits,
Not-for-profit Institutions; Number of Respondents: 10,229; Total
Annual Responses: 13,318,440; Total Annual Hours: 1,110,757. (For
policy questions regarding this collection contact Martha Kuespert at
(410) 786-4605.)
4. Type of Information Collection Request: Revision of a previously
approved collection; Title of Information Collection: End Stage Renal
Disease (ESRD) Network Semi-Annual Cost Report Forms and Supporting
Regulations; Use: Section 1881(c) of the Social Security Act
establishes End Stage Renal Disease (ESRD) Network contracts. The
regulations found at 42 CFR 405.2110 and 405.2112 designated 18 ESRD
Networks which are funded by renewable contracts. These contracts are
on 3-year cycles. To better administer the program, CMS is requiring
contractors to submit semi-annual cost reports. The purpose of the cost
reports is to enable the ESRD Networks to report costs in a
standardized manner. This will allow CMS to review, compare and project
ESRD Network costs during the life of the contract. Form Number: CMS-
685 (OMB Control Number: 0938-0657); Frequency: Reporting--Semi-
annually; Affected Public: Not-for-profit institutions; Number of
Respondents: 18; Total Annual Responses: 36; Total Annual Hours: 108.
(For policy questions regarding this collection contact Benjamin
Bernstein at 410-786-6570).
Dated: February 26, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2020-04242 Filed 2-28-20; 8:45 am]
BILLING CODE 4120-01-P
