Agency Information Collection Activities: Submission for OMB Review; Comment Request, 63116-63117 [2020-22090]
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Federal Register / Vol. 85, No. 194 / Tuesday, October 6, 2020 / Notices
program these Star Ratings were used
only to provide additional information
for beneficiaries to consider in making
their Part C and D plan elections.
Additionally, section 1854(b)(1)(C)(v) of
the Act, as added by the Affordable Care
Act, also requires CMS to change the
share of savings that MA organizations
must provide to enrollees as the
beneficiary rebate specified at
§ 422.266(a) based on the level of a
sponsor’s Star Rating for quality
performance.
The information collected on the
Request for Reconsideration form from
MA organizations is considered by the
reconsideration official and potentially
the hearing officer to review CMS’s
determination of the organization’s
eligibility for a QBP. The form asks MA
organizations to select the Star Ratings
measure(s) they believe was
miscalculated or used incorrect data and
describe what they believe is the issue.
Under § 422.260(c)(3)(ii) these are the
only bases for appeals. In conducting
the reconsideration, the reconsideration
official will review the QBP
determination, the evidence and
findings upon which it was based, and
any other written evidence submitted by
the organization with their Request for
Reconsideration or by CMS before the
reconsideration determination is made.
The administrative review process is
a two-step process that includes a
request for reconsideration and a
request for an informal hearing on the
record after CMS has sent the MA
organization the reconsideration
decision. Both steps are conducted at
the contract level. The first step allows
the MA organization to request a
reconsideration of how its Star Rating
for the given measure in question was
calculated and/or what data were
included in the measure. If the MA
organization is dissatisfied with CMS’s
reconsideration decision, the contract
may request an informal hearing to be
conducted by a hearing officer
designated by CMS. MA organizations
will have 10 business days from the
time we issue the notice of QBP status
to submit a request for reconsideration.
MA organizations will have 10 business
days after the issuance of the
reconsideration determination to
request an informal hearing on the
record. Form Number: CMS–10346
(OMB control number: 0938–1129);
Frequency: Yearly; Affected Public:
Private Sector, Business or other forprofits, Not-for-profit institutions;
Number of Respondents: 20; Total
Annual Responses: 20; Total Annual
Hours: 160. (For policy questions
regarding this collection contact Joy
Binion at 410–786–6567.)
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2. Type of Information Collection
Request: Revision with change of a
currently approved collection; Title of
Information Collection: Bid Pricing Tool
(BPT) for Medicare Advantage (MA)
Plans and Prescription Drug Plans
(PDP); Use: This collection dates back to
2005. Under the Medicare Prescription
Drug, Improvement, and Modernization
Act of 2003 (MMA), and implementing
regulations at 42 CFR, Medicare
Advantage organizations (MAO) and
Prescription Drug Plans (PDP) are
required to submit an actuarial pricing
‘‘bid’’ for each plan offered to Medicare
beneficiaries for approval by the Centers
for Medicare & Medicaid Services
(CMS). MAOs and PDPs use the Bid
Pricing Tool (BPT) software to develop
their actuarial pricing bid. The
competitive bidding process defined by
the ‘‘The Medicare Prescription Drug,
Improvement, and Modernization Act’’
(MMA) applies to both the MA and Part
D programs. It is an annual process that
encompasses the release of the MA rate
book in April, the bid’s that plans
submit to CMS in June, and the release
of the Part D and RPPO benchmarks,
which typically occurs in August. Form
Number: CMS–10142 (OMB control
number: 0938–0944); Frequency: Yearly;
Affected Public: State, Local, or Tribal
Governments; Number of Respondents:
555; Total Annual Responses: 4,995;
Total Annual Hours: 149,850. (For
policy questions regarding this
collection contact Rachel Shevland at
410–786–3026.)
3. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Fast Track
Appeals Notices: NOMNC/DENC; Use:
The purpose of the NOMNC is to help
a beneficiary/enrollee decide whether to
pursue a fast appeal by a Quality
Improvement Organization (QIO) and
how to file that request. Consistent with
§§ 405.1200 and 422.624, SNFs, HHAs,
CORFs, and hospices must provide
notice to all beneficiaries/enrollees
whose Medicare-covered services are
ending, no later than two days in
advance of the proposed termination of
service. This information is conveyed to
the beneficiary/enrollee via the
NOMNC.
If a beneficiary/enrollee appeals the
termination decision, the beneficiary/
enrollee and the QIO, consistent with
§§ 405.1200(b) and 405.1202(f) for
Original Medicare, and §§ 422.624(b)
and 422.626(e)(1)–(5) for Medicare
health plans, will receive a detailed
explanation of the reasons services
should end. This detailed explanation is
provided to the beneficiary/enrollee
using the DENC, the second notice
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Sfmt 4703
included in this renewal package. Form
Number: CMS–10123/10124 (OMB
control number: 0938–0953); Frequency:
Yearly; Affected Public: Private Sector,
Business or other for-profits, Not-forprofit institutions; Number of
Respondents: 24,915; Total Annual
Responses: 5,314,194; Total Annual
Hours: 1,142,749. (For policy questions
regarding this collection contact Janet
Miller at Janet.Miller@cms.hhs.gov.)
Dated: October 1, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2020–22089 Filed 10–5–20; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10261 & CMS–
10636]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Centers for Medicare &
Medicaid Services, Health and Human
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.
SUMMARY:
Comments on the collection(s) of
information must be received by the
OMB desk officer by November 5, 2020.
DATES:
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Federal Register / Vol. 85, No. 194 / Tuesday, October 6, 2020 / Notices
Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function.
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. 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
previously approved collection; Title of
Information Collection: Part C Medicare
Advantage Reporting Requirements and
Supporting Regulations in 42 CFR
422.516(a); Use: Section 1852(m) of the
Social Security Act (the Act) and CMS
regulations at 42 CFR 422.135 allow
Medicare Advantage (MA) plans the
ability to provide ‘‘additional telehealth
benefits’’ to enrollees starting in plan
year 2020 and treat them as basic
benefits. MA additional telehealth
benefits are limited to services for
which benefits are available under
Medicare Part B but which are not
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payable under section 1834(m) of the
Act. In addition, MA additional
telehealth benefits are services that been
identified by the MA plan for the
applicable year as clinically appropriate
to furnish through electronic
information and telecommunications
technology (or ‘‘electronic exchange’’)
when the physician (as defined in
section 1861(r) of the Act) or
practitioner (as defined in section
1842(b)(18)(C) of the Act) providing the
service is not in the same location as the
enrollee. Per § 422.135(d), MA plans
may only furnish MA additional
telehealth benefits using contracted
providers. The data collected in this
measure will provide CMS with a better
understanding of the number of
organizations utilizing Telehealth per
contract and to also capture those
specialties used for both in-person and
Telehealth. This data will allow CMS to
improve its policy and process
surrounding Telehealth. In addition, the
specialist and facility data we are
collecting aligns with some of the
provider and facility specialty types that
organizations are required to include in
their networks and to submit on their
HSD tables in the Network Management
Module in Health Plan Management
System. Form Number: CMS–10261
(OMB control number 0938–1054);
Frequency: Occasionally; Affected
Public: State, Local, and Tribal
Governments; Number of Respondents:
759; Total Annual Responses: 5,313;
Total Annual Hours: 224,664 (For
policy questions regarding this
collection contact Maria Sotirelis at
410–786–0552.)
2. Type of Information Collection
Request: Revision with change of a
previously approved collection; Title of
Information Collection: Triennial
Network Adequacy Review for Medicare
Advantage Organizations and 1876 Cost
Plans; Use: CMS regulations at 42 CFR
417.414, 417.416, 422.112(a)(1)(i), and
422.114(a)(3)(ii) require that all
Medicare Advantage organizations
(MAOs) offering coordinated care plans,
network-based private fee-for-service
(PFFS) plans, and as well as section
1876 cost organizations, maintain a
network of appropriate providers that is
sufficient to provide adequate access to
covered services to meet the needs of
the population served. To enforce this
requirement, CMS developed network
adequacy criteria which set forth the
minimum number of providers and
maximum travel time and distance from
enrollees to providers, for required
provider specialty types in each county
in the United States and its territories.
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63117
Organizations must be in compliance
with the current CMS network adequacy
criteria guidance, which is updated and
published annually on CMS’s website.
Additional network policy guidance is
also located in chapter 4 of the Medicare
Managed Care Manual. This collection
of information is essential to
appropriate and timely compliance
monitoring by CMS, in order to ensure
that all active contracts offering
network-based plans maintain an
adequate network.
CMS verifies that organizations are
compliant with the CMS network
adequacy criteria by performing a
contract-level network review, which
occurs when CMS requests an
organization upload provider and
facility Health Service Delivery (HSD)
tables for a given contract to the Health
Plan Management System (HPMS). CMS
reviews networks on a three-year cycle,
unless there is an event that triggers an
intermediate full network review, thus
resetting the organization’s triennial
review. The triennial review cycle will
help ensure a consistent process for
network oversight and monitoring.
Once CMS staff reviews the ACC
reports and any Exception Requests
and/or Partial County Justifications,
CMS then makes its final determination
on whether the organization is operating
in compliance with current CMS
network adequacy criteria. If the
organization passes its network review
for a given contract, then CMS will take
no further action. If the organization
fails its network review for a given
contract, then CMS will take
appropriate compliance actions. CMS
has developed a compliance
methodology for network adequacy
reviews that will ensure a consistent
approach across all organizations. Form
Number: CMS–10636 (OMB control
number 0938–1346); Frequency:
Occasionally; Affected Public: State,
Local, and Tribal Governments; Number
of Respondents: 140; Total Annual
Responses: 1,416; Total Annual Hours:
13,372. (For policy questions regarding
this collection contact Amber Casserly
at 410–786–5530.)
Dated: October 1, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2020–22090 Filed 10–5–20; 8:45 am]
BILLING CODE 4120–01–P
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]]>Agencies
[Federal Register Volume 85, Number 194 (Tuesday, October 6, 2020)]
[Notices]
[Pages 63116-63117]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-22090]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10261 & CMS-10636]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, Health and Human
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 November 5, 2020.
[[Page 63117]]
ADDRESSES: Written comments and recommendations for the proposed
information collection should be sent within 30 days of publication of
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function.
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. 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 previously approved collection; Title of Information Collection: Part
C Medicare Advantage Reporting Requirements and Supporting Regulations
in 42 CFR 422.516(a); Use: Section 1852(m) of the Social Security Act
(the Act) and CMS regulations at 42 CFR 422.135 allow Medicare
Advantage (MA) plans the ability to provide ``additional telehealth
benefits'' to enrollees starting in plan year 2020 and treat them as
basic benefits. MA additional telehealth benefits are limited to
services for which benefits are available under Medicare Part B but
which are not payable under section 1834(m) of the Act. In addition, MA
additional telehealth benefits are services that been identified by the
MA plan for the applicable year as clinically appropriate to furnish
through electronic information and telecommunications technology (or
``electronic exchange'') when the physician (as defined in section
1861(r) of the Act) or practitioner (as defined in section
1842(b)(18)(C) of the Act) providing the service is not in the same
location as the enrollee. Per Sec. 422.135(d), MA plans may only
furnish MA additional telehealth benefits using contracted providers.
The data collected in this measure will provide CMS with a better
understanding of the number of organizations utilizing Telehealth per
contract and to also capture those specialties used for both in-person
and Telehealth. This data will allow CMS to improve its policy and
process surrounding Telehealth. In addition, the specialist and
facility data we are collecting aligns with some of the provider and
facility specialty types that organizations are required to include in
their networks and to submit on their HSD tables in the Network
Management Module in Health Plan Management System. Form Number: CMS-
10261 (OMB control number 0938-1054); Frequency: Occasionally; Affected
Public: State, Local, and Tribal Governments; Number of Respondents:
759; Total Annual Responses: 5,313; Total Annual Hours: 224,664 (For
policy questions regarding this collection contact Maria Sotirelis at
410-786-0552.)
2. Type of Information Collection Request: Revision with change of
a previously approved collection; Title of Information Collection:
Triennial Network Adequacy Review for Medicare Advantage Organizations
and 1876 Cost Plans; Use: CMS regulations at 42 CFR 417.414, 417.416,
422.112(a)(1)(i), and 422.114(a)(3)(ii) require that all Medicare
Advantage organizations (MAOs) offering coordinated care plans,
network-based private fee-for-service (PFFS) plans, and as well as
section 1876 cost organizations, maintain a network of appropriate
providers that is sufficient to provide adequate access to covered
services to meet the needs of the population served. To enforce this
requirement, CMS developed network adequacy criteria which set forth
the minimum number of providers and maximum travel time and distance
from enrollees to providers, for required provider specialty types in
each county in the United States and its territories. Organizations
must be in compliance with the current CMS network adequacy criteria
guidance, which is updated and published annually on CMS's website.
Additional network policy guidance is also located in chapter 4 of the
Medicare Managed Care Manual. This collection of information is
essential to appropriate and timely compliance monitoring by CMS, in
order to ensure that all active contracts offering network-based plans
maintain an adequate network.
CMS verifies that organizations are compliant with the CMS network
adequacy criteria by performing a contract-level network review, which
occurs when CMS requests an organization upload provider and facility
Health Service Delivery (HSD) tables for a given contract to the Health
Plan Management System (HPMS). CMS reviews networks on a three-year
cycle, unless there is an event that triggers an intermediate full
network review, thus resetting the organization's triennial review. The
triennial review cycle will help ensure a consistent process for
network oversight and monitoring.
Once CMS staff reviews the ACC reports and any Exception Requests
and/or Partial County Justifications, CMS then makes its final
determination on whether the organization is operating in compliance
with current CMS network adequacy criteria. If the organization passes
its network review for a given contract, then CMS will take no further
action. If the organization fails its network review for a given
contract, then CMS will take appropriate compliance actions. CMS has
developed a compliance methodology for network adequacy reviews that
will ensure a consistent approach across all organizations. Form
Number: CMS-10636 (OMB control number 0938-1346); Frequency:
Occasionally; Affected Public: State, Local, and Tribal Governments;
Number of Respondents: 140; Total Annual Responses: 1,416; Total Annual
Hours: 13,372. (For policy questions regarding this collection contact
Amber Casserly at 410-786-5530.)
Dated: October 1, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2020-22090 Filed 10-5-20; 8:45 am]
BILLING CODE 4120-01-P
