Agency Information Collection Activities: Proposed Collection; Comment Request, 68330-68332 [2020-23893]
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68330
Federal Register / Vol. 85, No. 209 / Wednesday, October 28, 2020 / Notices
Telephone: (513) 841–4515 (this is not
a toll-free number); Email:
TCarreonValencia@cdc.gov.
SUPPLEMENTARY INFORMATION:
Nominations are being sought for
individuals who have expertise and
qualifications necessary to contribute to
accomplishing the committee’s
objectives. The Administrator of the
WTC Health Program is seeking
nominations for members fulfilling the
following categories:
• Occupational physician who has
experience treating WTC rescue and
recovery workers;
• Environmental medicine/
environmental health professional;
• Toxicologist;
• Epidemiologist;
• Occupational physician;
• Representative of WTC responders;
and
• Representative of certified-eligible
WTC survivors.
Members may be invited to serve for
four-year terms. Selection of members is
based on candidates’ qualifications to
contribute to the accomplishment of
STAC objectives. More information on
the committee is available at https://
www.cdc.gov/wtc/stac.html. The U.S.
Department of Health and Human
Services (HHS) policy stipulates that
committee membership be balanced in
terms of points of view represented, and
the committee’s function. Appointments
shall be made without discrimination
on the basis of age, race, ethnicity,
gender, sexual orientation, gender
identity, HIV status, disability, and
cultural, religious, or socioeconomic
status. Nominees must be U.S. citizens.
Current participation on federal
workgroups or prior experience serving
on a federal advisory committee does
not disqualify a candidate; however,
HHS policy is to avoid excessive
individual service on advisory
committees and multiple committee
memberships. Committee members are
Special Government Employees,
requiring the filing of financial
disclosure reports at the beginning and
annually during their terms. NIOSH
identifies potential candidates and
provides a slate of nominees for
consideration to the Director of CDC for
STAC membership each year, CDC
reviews the proposed slate of
candidates, and provides a slate of
nominees for consideration to the
Secretary of HHS for final selection.
HHS notifies selected candidates of
their appointment near the start of the
term in October, or as soon as the HHS
selection process is completed. Note
that the need for different expertise
varies from year to year and a candidate
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18:29 Oct 27, 2020
Jkt 253001
who is not selected in one year may be
reconsidered in a subsequent year.
Candidates should submit the
following items:
D Current curriculum vitae, including
complete contact information
(telephone numbers, mailing address,
email address);
D The category of membership
(environmental medicine or
environmental health specialist,
occupational physician, pulmonary
physician, representative of WTC
responders, certified-eligible WTC
survivor representative, industrial
hygienist, toxicologist, epidemiologist,
or mental health professional) that the
candidate is qualified to represent);
D A summary of the background,
experience, and qualifications that
demonstrates the candidate’s suitability
for the nominated membership category;
and
D At least one letter of
recommendation from person(s) not
employed by the U.S. Department of
Health and Human Services.
(Candidates may submit letter(s) from
current HHS employees if they wish,
but at least one letter must be submitted
by a person not employed by an HHS
agency (e.g., CDC, NIH, FDA, etc.).
Nominations may be submitted by the
candidate him- or herself, or by the
person/organization recommending the
candidate. The Director, Strategic
Business Initiatives Unit, Office of the
Chief Operating Officer, Centers for
Disease Control and Prevention, has
been delegated the authority to sign
Federal Register notices pertaining to
announcements of meetings and other
committee management activities, for
both the Centers for Disease Control and
Prevention and the Agency for Toxic
Substances and Disease Registry.
Kalwant Smagh,
Director, Strategic Business Initiatives Unit,
Office of the Chief Operating Officer, Centers
for Disease Control and Prevention.
[FR Doc. 2020–23803 Filed 10–27–20; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10307 and CMS–
10495]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, Health and Human
Services (HHS).
AGENCY:
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ACTION:
Notice.
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 28, 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
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 Numberlll, 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. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
William N. Parham at (410) 786–4669.
SUMMARY:
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Federal Register / Vol. 85, No. 209 / Wednesday, October 28, 2020 / Notices
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–10307 Medical Necessity and
Claims Denial Disclosures under
MHPAEA
CMS–10495 Data Collection and
Submission, Registration, Attestation,
Dispute and Resolution, Record
Retention, and Assumptions
Document Submission, for Open
Payments
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.
jbell on DSKJLSW7X2PROD with NOTICES
Information Collection
1. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Medical
Necessity and Claims Denial Disclosures
under MHPAEA; Use: The Paul
Wellstone and Pete Domenici Mental
Health Parity and Addiction Equity Act
of 2008 (MHPAEA) (P.L.110–343)
generally requires that group health
plans and group health insurance
issuers offering mental health or
substance use disorder (MH/SUD)
benefits in addition to medical and
surgical (med/surg) benefits ensure that
they do not apply any more restrictive
financial requirements (e.g., co-pays,
deductibles) and/or treatment
limitations (e.g., visit limits) to MH/SUD
benefits than those requirements and/or
limitations applied to substantially all
med/surg benefits.
The Patient Protection and Affordable
Care Act, Public Law 111–148, was
enacted on March 23, 2010, and the
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Jkt 253001
Health Care and Education
Reconciliation Act of 2010, Public Law
111–152, was enacted on March 30,
2010, collectively known as the
‘‘Affordable Care Act.’’ The Affordable
Care Act extended MHPAEA to apply to
the individual health insurance market.
Additionally, the Department of Health
and Human Services (HHS) final
regulation regarding essential health
benefits (EHB) requires health insurance
issuers offering non-grandfathered
health insurance coverage in the
individual and small group markets,
through an Exchange or outside of an
Exchange, to comply with the
requirements of the MHPAEA
regulations in order to satisfy the
requirement to cover EHB (45 CFR
147.150 and 156.115).
MHPAEA section 512(b) specifically
amends the Public Health Service (PHS)
Act to require plan administrators or
health insurance issuers to provide,
upon request, the criteria for medical
necessity determinations made with
respect to MH/SUD benefits to current
or potential participants, beneficiaries,
or contracting providers. The Interim
Final Rules Under the Paul Wellstone
and Pete Domenici Mental Health Parity
and Addiction Equity Act of 2008 (75
FR 5410, February 2, 2010) and the
Final Rules under the Paul Wellstone
and Pete Domenici Mental Health Parity
and Addiction Equity Act of 2008 set
forth rules for providing criteria for
medical necessity determinations. CMS
oversees non-Federal governmental
plans and health insurance issuers.
MHPAEA section 512(b) specifically
amends the PHS Act to require plan
administrators or health insurance
issuers to supply, upon request, the
reason for any denial or reimbursement
of payment for MH/SUD services to the
participant or beneficiary involved in
the case. The Interim Final Rules Under
the Paul Wellstone and Pete Domenici
Mental Health Parity and Addiction
Equity Act of 2008 (75 FR 5410,
February 2, 2010) and the Final Rules
under the Paul Wellstone and Pete
Domenici Mental Health Parity and
Addiction Equity Act of 2008
implement 45 CFR 146.136(d)(2), which
sets forth rules for providing reasons for
claims denial. CMS oversees nonFederal governmental plans and health
insurance issuers, and the regulation
provides a safe harbor such that nonFederal governmental plans (and issuers
offering coverage in connection with
such plans) are deemed to comply with
requirements of paragraph (d)(2) of 45
CFR 146.136 if they provide the reason
for claims denial in a form and manner
consistent with ERISA requirements
found in 29 CFR 2560.503–1. Section
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Frm 00047
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Sfmt 4703
68331
146.136(d)(3) of the final rule clarifies
that PHS Act section 2719 governing
internal claims and appeals and external
review as implemented by 45 CFR
147.136, covers MHPAEA claims
denials and requires that, when a nonquantitative treatment limitation
(NQTL) is the basis for a claims denial,
that a non-grandfathered plan or issuer
must provide the processes, strategies,
evidentiary standard, and other factors
used in developing and applying the
NQTL with respect to med/surg benefits
and MH/SUD benefits.
Group health plan participants,
beneficiaries, covered individuals in the
individual market, or persons acting on
their behalf, may use this optional
model form to request information from
plans regarding NQTLs that may affect
patients’ MH/SUD benefits or that may
have resulted in their coverage being
denied. Form Number: CMS–10307
(OMB control number: 0938–1080);
Frequency: On Occasion; Affected
Public: State, Local, or Tribal
Governments, Private Sector,
Individuals; Number of Respondents:
250,137; Total Annual Responses:
987,714; Total Annual Hours: 35,475.
(For policy questions regarding this
collection contact Usree
Bandyopadhyay at 410–786–6650.)
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Data Collection
and Submission, Registration,
Attestation, Dispute and Resolution,
Record Retention, and Assumptions
Document Submission, for Open
Payments; Use: Section 6002 of the
Affordable Care Act added section
1128G to the Social Security Act (the
Act), which requires applicable
manufacturers of covered drugs,
devices, biologicals, or medical supplies
(as defined at 42 CFR 403.902) to report
annually to the Secretary certain
payments or other transfers of value to
covered recipients. Section 1128G of the
Act also requires applicable
manufacturers and applicable group
purchasing organizations (GPOs) to
report certain information regarding the
ownership or investment interests held
by physicians or the immediate family
members of physicians in such entities.
Specifically, manufacturers of covered
drugs, devices, biologicals, and medical
supplies (applicable manufacturers) are
required to submit on an annual basis
the information required in section
1128G(a)(1) of the Act about certain
payments or other transfers of value
made to covered recipients during the
course of the preceding calendar year.
Similarly, section 1128G(a)(2) of the Act
requires applicable manufacturers and
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Federal Register / Vol. 85, No. 209 / Wednesday, October 28, 2020 / Notices
applicable GPOs to disclose any
ownership or investment interests in
such entities held by physicians or their
immediate family members, as well as
information on any payments or other
transfers of value provided to such
physician owners or investors. Form
Number: CMS–10495 (OMB control
number: 0938–1237); Frequency: Once;
Affected Public: Private sector; Business
or other for-profits; Number of
Respondents: 34,616; Total Annual
Responses: 78,812; Total Annual Hours:
1,897,790. (For policy questions
regarding this collection contact
Kathleen Ott 410–786–4246.)
Dated: October 23, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2020–23893 Filed 10–27–20; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10570 and CMS–
10437]
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
jbell on DSKJLSW7X2PROD with NOTICES
SUMMARY:
VerDate Sep<11>2014
18:29 Oct 27, 2020
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for Certain Imaging Services,’’ which
directs the Secretary to establish a
program to promote the use of AUC.
DATES: Comments on the collection(s) of
This program is codified at 42 CFR
information must be received by the
414.94. Evidence-based AUC for
OMB desk officer by November 27,
imaging can assist clinicians in selecting
2020.
the imaging study that is most likely to
ADDRESSES: Written comments and
improve health outcomes for patients
recommendations for the proposed
based on their individual context. A
information collection should be sent
provider-led entity (PLE) as defined in
within 30 days of publication of this
42 CFR 414.94(b) is a national
notice to www.reginfo.gov/public/do/
professional medical specialty society or
PRAMain. Find this particular
other organization that is comprised
information collection by selecting
primarily of providers or practitioners
‘‘Currently under 30-day Review—Open who, either within the organization or
for Public Comments’’ or by using the
outside the organization, predominantly
search function.
provide direct patient care. This
To obtain copies of a supporting
program requires professionals ordering
statement and any related forms for the
applicable imaging services as defined
proposed collection(s) summarized in
in § 414.94(b) to consult with specified
applicable AUC, which are criteria
this notice, you may make your request
developed, endorsed or modified by a
using one of following:
qualified PLE.
1. Access CMS’ website address at
The cornerstone of the PLE
website address at https://www.cms.gov/
qualification process is for PLEs to
Regulations-and-Guidance/Legislation/
demonstrate that they engage in a
PaperworkReductionActof1995/PRArigorous evidence-based process for
Listing.html.
2. Call the Reports Clearance Office at developing, modifying, or endorsing
AUC. Section 1834(q)(2)(B) specifies
(410) 786–1326.
that the Secretary must consider
FOR FURTHER INFORMATION CONTACT:
whether AUC have stakeholder
William Parham at (410) 786–4669.
consensus, are scientifically valid and
SUPPLEMENTARY INFORMATION: Under the
evidence-based, and are based on
Paperwork Reduction Act of 1995 (PRA) studies that are published and
(44 U.S.C. 3501–3520), federal agencies
reviewable by stakeholders. In the 2016
must obtain approval from the Office of
Physician Fee Schedule Final Rule with
Management and Budget (OMB) for each comment period (80 FR 70886,
collection of information they conduct
November 16, 2015; see pages 71102–
or sponsor. The term ‘‘collection of
71116 and pages 71380–71382) we
information’’ is defined in 44 U.S.C.
established a qualification process and
3502(3) and 5 CFR 1320.3(c) and
requirements for qualified PLEs in order
includes agency requests or
to ensure that the AUC development or
requirements that members of the public endorsement processes used by a PLE
submit reports, keep records, or provide result in high quality, evidence-based
information to a third party. Section
AUC in accordance with section
3506(c)(2)(A) of the PRA (44 U.S.C.
1834(q)(2)(B).
3506(c)(2)(A)) requires federal agencies
In order to become and remain a
to publish a 30-day notice in the
qualified PLE, we require PLEs to
Federal Register concerning each
demonstrate adherence to specific
proposed collection of information,
requirements when developing,
including each proposed extension or
modifying or endorsing AUC. To ensure
reinstatement of an existing collection
that these requirements are met, we
of information, before submitting the
require PLEs to submit information
collection to OMB for approval. To
demonstrating their adherence to these
comply with this requirement, CMS is
requirements. CMS qualifies those PLEs
publishing this notice that summarizes
that demonstrate adherence to the
the following proposed collection(s) of
requirements for a period of five years.
information for public comment:
Qualified PLEs are also required, during
1. Type of Information Collection
the 5th year after their most recent
Request: Reinstatement of a previously
approval date, to ensure adherence has
approved collection; Title of
been maintained and to account for any
Information Collection: Appropriate Use changes in the entities’ processes.
Criteria (AUC) for Advanced Diagnostic Qualified PLEs must reapply every five
Imaging Services; Use: Section 218(b) of years and must submit the applications
the Protecting Access to Medicare Act
by January 1 of the 5th year after the
(PAMA) of 2014 amended the Medicare PLE’s most recent approval date. Form
Number: CMS–10570 (OMB control
Part B statute by adding a new section
number: 0938–1288); Frequency:
1834(q) of the Act entitled,
Occasionally; Affected Public: Private:
‘‘Recognizing Appropriate Use Criteria
minimize the information collection
burden.
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Agencies
[Federal Register Volume 85, Number 209 (Wednesday, October 28, 2020)]
[Notices]
[Pages 68330-68332]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-23893]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10307 and CMS-10495]
Agency Information Collection Activities: Proposed Collection;
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 (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 28, 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 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. Call the Reports Clearance Office at (410) 786-1326.
FOR FURTHER INFORMATION CONTACT: William N. Parham at (410) 786-4669.
[[Page 68331]]
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-10307 Medical Necessity and Claims Denial Disclosures under MHPAEA
CMS-10495 Data Collection and Submission, Registration, Attestation,
Dispute and Resolution, Record Retention, and Assumptions Document
Submission, for Open Payments
Under the PRA (44 U.S.C. 3501-3520), federal agencies must obtain
approval from the Office of Management and Budget (OMB) for each
collection of information they conduct or sponsor. The term
``collection of information'' is defined in 44 U.S.C. 3502(3) and 5 CFR
1320.3(c) and includes agency requests or requirements that members of
the public submit reports, keep records, or provide information to a
third party. Section 3506(c)(2)(A) of the PRA requires federal agencies
to publish a 60-day notice in the Federal Register concerning each
proposed collection of information, including each proposed extension
or reinstatement of an existing collection of information, before
submitting the collection to OMB for approval. To comply with this
requirement, CMS is publishing this notice.
Information Collection
1. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medical Necessity
and Claims Denial Disclosures under MHPAEA; Use: The Paul Wellstone and
Pete Domenici Mental Health Parity and Addiction Equity Act of 2008
(MHPAEA) (P.L.110-343) generally requires that group health plans and
group health insurance issuers offering mental health or substance use
disorder (MH/SUD) benefits in addition to medical and surgical (med/
surg) benefits ensure that they do not apply any more restrictive
financial requirements (e.g., co-pays, deductibles) and/or treatment
limitations (e.g., visit limits) to MH/SUD benefits than those
requirements and/or limitations applied to substantially all med/surg
benefits.
The Patient Protection and Affordable Care Act, Public Law 111-148,
was enacted on March 23, 2010, and the Health Care and Education
Reconciliation Act of 2010, Public Law 111-152, was enacted on March
30, 2010, collectively known as the ``Affordable Care Act.'' The
Affordable Care Act extended MHPAEA to apply to the individual health
insurance market. Additionally, the Department of Health and Human
Services (HHS) final regulation regarding essential health benefits
(EHB) requires health insurance issuers offering non-grandfathered
health insurance coverage in the individual and small group markets,
through an Exchange or outside of an Exchange, to comply with the
requirements of the MHPAEA regulations in order to satisfy the
requirement to cover EHB (45 CFR 147.150 and 156.115).
MHPAEA section 512(b) specifically amends the Public Health Service
(PHS) Act to require plan administrators or health insurance issuers to
provide, upon request, the criteria for medical necessity
determinations made with respect to MH/SUD benefits to current or
potential participants, beneficiaries, or contracting providers. The
Interim Final Rules Under the Paul Wellstone and Pete Domenici Mental
Health Parity and Addiction Equity Act of 2008 (75 FR 5410, February 2,
2010) and the Final Rules under the Paul Wellstone and Pete Domenici
Mental Health Parity and Addiction Equity Act of 2008 set forth rules
for providing criteria for medical necessity determinations. CMS
oversees non-Federal governmental plans and health insurance issuers.
MHPAEA section 512(b) specifically amends the PHS Act to require
plan administrators or health insurance issuers to supply, upon
request, the reason for any denial or reimbursement of payment for MH/
SUD services to the participant or beneficiary involved in the case.
The Interim Final Rules Under the Paul Wellstone and Pete Domenici
Mental Health Parity and Addiction Equity Act of 2008 (75 FR 5410,
February 2, 2010) and the Final Rules under the Paul Wellstone and Pete
Domenici Mental Health Parity and Addiction Equity Act of 2008
implement 45 CFR 146.136(d)(2), which sets forth rules for providing
reasons for claims denial. CMS oversees non-Federal governmental plans
and health insurance issuers, and the regulation provides a safe harbor
such that non-Federal governmental plans (and issuers offering coverage
in connection with such plans) are deemed to comply with requirements
of paragraph (d)(2) of 45 CFR 146.136 if they provide the reason for
claims denial in a form and manner consistent with ERISA requirements
found in 29 CFR 2560.503-1. Section 146.136(d)(3) of the final rule
clarifies that PHS Act section 2719 governing internal claims and
appeals and external review as implemented by 45 CFR 147.136, covers
MHPAEA claims denials and requires that, when a non-quantitative
treatment limitation (NQTL) is the basis for a claims denial, that a
non-grandfathered plan or issuer must provide the processes,
strategies, evidentiary standard, and other factors used in developing
and applying the NQTL with respect to med/surg benefits and MH/SUD
benefits.
Group health plan participants, beneficiaries, covered individuals
in the individual market, or persons acting on their behalf, may use
this optional model form to request information from plans regarding
NQTLs that may affect patients' MH/SUD benefits or that may have
resulted in their coverage being denied. Form Number: CMS-10307 (OMB
control number: 0938-1080); Frequency: On Occasion; Affected Public:
State, Local, or Tribal Governments, Private Sector, Individuals;
Number of Respondents: 250,137; Total Annual Responses: 987,714; Total
Annual Hours: 35,475. (For policy questions regarding this collection
contact Usree Bandyopadhyay at 410-786-6650.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Data Collection
and Submission, Registration, Attestation, Dispute and Resolution,
Record Retention, and Assumptions Document Submission, for Open
Payments; Use: Section 6002 of the Affordable Care Act added section
1128G to the Social Security Act (the Act), which requires applicable
manufacturers of covered drugs, devices, biologicals, or medical
supplies (as defined at 42 CFR 403.902) to report annually to the
Secretary certain payments or other transfers of value to covered
recipients. Section 1128G of the Act also requires applicable
manufacturers and applicable group purchasing organizations (GPOs) to
report certain information regarding the ownership or investment
interests held by physicians or the immediate family members of
physicians in such entities.
Specifically, manufacturers of covered drugs, devices, biologicals,
and medical supplies (applicable manufacturers) are required to submit
on an annual basis the information required in section 1128G(a)(1) of
the Act about certain payments or other transfers of value made to
covered recipients during the course of the preceding calendar year.
Similarly, section 1128G(a)(2) of the Act requires applicable
manufacturers and
[[Page 68332]]
applicable GPOs to disclose any ownership or investment interests in
such entities held by physicians or their immediate family members, as
well as information on any payments or other transfers of value
provided to such physician owners or investors. Form Number: CMS-10495
(OMB control number: 0938-1237); Frequency: Once; Affected Public:
Private sector; Business or other for-profits; Number of Respondents:
34,616; Total Annual Responses: 78,812; Total Annual Hours: 1,897,790.
(For policy questions regarding this collection contact Kathleen Ott
410-786-4246.)
Dated: October 23, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2020-23893 Filed 10-27-20; 8:45 am]
BILLING CODE 4120-01-P