80 FR 52478 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of Management and Budget (OMB)

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services

Federal Register Volume 80, Issue 168 (August 31, 2015)

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. Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including any of the following subjects: (1) The necessity and utility of the proposed information collection for the proper performance of the agency's functions; (2) the accuracy of the estimated burden; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) the use of automated collection techniques or other forms of information technology to minimize the information collection burden. We are, however, requesting an emergency review of the information collection referenced below. In compliance with the requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, we have submitted to the Office of Management and Budget (OMB) the following requirements for emergency review. This is necessary to ensure compliance with an initiative of the Administration. We are requesting an emergency review under 5 CFR 1320.13(a)(2)(i) because public harm is reasonably likely to result if the normal clearance procedures are followed. We are seeking emergency approval for modifications to the information collection request (ICR) currently approved under Office of Management and Budget (OMB) control number 0938-1155. CMS seeks an emergency revision to the ICR approved under 0938-1155 to collect additional information from health insurance companies as part of the MLR and risk corridors programs. This ICR is necessary to validate data that issuers have previously submitted to CMS in more detail than CMS has previously anticipated. While conducting program integrity reviews of submitted data, CMS has identified a number of significant discrepancies in the 2014 benefit year submissions that issuers made for MLR and risk corridors on July 31, 2015. CMS also identified a number of common errors that may lead to submissions that do not comply with CMS regulations and guidance. In order to resolve these potential discrepancies, ensure all submissions comply with applicable guidance, and operate the MLR and risk corridors program accurately and effectively, CMS needs additional information to explain the data found in issuers' underlying MLR and risk corridors submissions. Without this additional information, CMS will be unable to verify the accuracy of the submission and validate the data needed to operate the MLR or risk corridors programs.

[Federal Register Volume 80, Number 168 (Monday, August 31, 2015)]
[Notices]
[Pages 52478-52479]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-21476]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-10401]


Emergency Clearance: Public Information Collection Requirements 
Submitted to the Office of Management and Budget (OMB)

AGENCY: Centers for Medicare & Medicaid Services.

ACTION: Notice.

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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. Interested persons are invited to send comments regarding 
our burden estimates or any other aspect of this collection of 
information, including any of the following subjects: (1) The necessity 
and utility of the proposed information collection for the proper 
performance of the agency's functions; (2) the accuracy of the 
estimated burden; (3) ways to enhance the quality, utility, and clarity 
of the information to be collected; and (4) the use of automated 
collection techniques or other forms of information technology to 
minimize the information collection burden.
    We are, however, requesting an emergency review of the information 
collection referenced below. In compliance with the requirement of 
section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, we have 
submitted to the Office of Management and Budget (OMB) the following 
requirements for emergency review. This is necessary to ensure 
compliance with an initiative of the Administration. We are requesting 
an emergency review under 5 CFR 1320.13(a)(2)(i) because public harm is 
reasonably likely to result if the normal clearance procedures are 
followed. We are seeking emergency approval for modifications to the 
information collection request (ICR) currently approved under Office of 
Management and Budget (OMB) control number 0938-1155. CMS seeks an 
emergency revision to the ICR approved under 0938-1155 to collect 
additional information from health insurance companies as part of the 
MLR and risk corridors programs. This ICR is necessary to validate data 
that issuers have previously submitted to CMS in more detail than CMS 
has previously anticipated. While conducting program integrity reviews 
of submitted data, CMS has identified a number of significant 
discrepancies in the 2014 benefit year submissions that issuers made 
for MLR and risk corridors on July 31, 2015. CMS also identified a 
number of common errors that may lead to submissions that do not comply 
with CMS regulations and guidance. In order to resolve these potential 
discrepancies, ensure all submissions comply with applicable guidance, 
and operate the MLR and risk corridors program accurately and 
effectively, CMS needs additional information to explain the data found 
in issuers' underlying MLR and risk corridors submissions. Without this 
additional information, CMS will be unable to verify the accuracy of 
the submission and validate the data needed to operate the MLR or risk 
corridors programs.

DATES: Comments must be received by September 3, 2015.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number. To be assured consideration, comments and 
recommendations must be submitted in any one of the following ways:
    1. Electronically. You may send your comments electronically to 
http://www.regulations.gov. Follow the instructions for ``Comment or 
Submission'' or ``More Search Options'' to find the information 
collection document(s) that are accepting comments.
    2. By regular mail. You may mail written comments to the following 
address: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: CMS-10401/OMB Control 
Number 0938-1155, Room C4-26-05, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.
    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, you may make 
your request using one of following:
    1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to [email protected].
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.

SUPPLEMENTARY INFORMATION:

[[Page 52479]]

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-10401 Standards Related to Reinsurance, Risk Corridors, and Risk 
Adjustment

    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. In compliance with the requirement of section 
3506(c)(2)(A) of the Paperwork Reduction Act of 1995, we have submitted 
to the Office of Management and Budget (OMB) the following requirements 
for emergency review. This is necessary to ensure compliance with an 
initiative of the Administration. We are requesting an emergency review 
under 5 CFR 1320.13(a)(2)(i) because public harm is reasonably likely 
to result if the normal clearance procedures are followed.

Information Collection

    1. Type of Information Collection Request: Revision of a currently 
approved information collection; Title of Information Collection: 
Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment; 
Use: Under Section 1342 of the Patient Protection and Affordable Care 
Act and implementing regulation at 45 CFR part 153, issuers of 
qualified health plans (QHPs) must participate in a risk corridors 
program. A QHP issuer will pay risk corridors charges or be eligible to 
receive risk corridors payments or based on the ratio of the issuer's 
allowable costs to the target amount. A final rule (Standards Related 
to Reinsurance, Risk Corridors and Risk Adjustment) implementing the 
risk corridors program was published on March 23, 2012 (77 FR 17220), 
which added part 153 to title 45 of the Code of Federal Regulations. 
Final rules (2014, 2015, and 2016 Payment Notices) outlining the risk 
corridors benefit and payment parameters for the 2014, 2015, and 2016 
benefit years were published on March 11, 2013 (78 FR 15410), March 11, 
2014 (79 FR 13744), and February 27, 2015 (80 FR 10750), respectively. 
Additionally, on October 30, 2013, HHS published the Second Final 
Program Integrity rule (78 FR 65076) to align the risk corridors 
program with the requirements of the single risk pool provision at 45 
CFR 156.80. The risk corridors data collection applies to QHP issuers 
the individual and small group markets. Each QHP issuer is required to 
submit an annual report to CMS concerning the issuer's allowable costs, 
allowable administrative costs, premium, and proportion of market 
premium in QHPs. Risk corridors premium information that is specific to 
an issuer's QHPs is collected through a separate data reporting form.
    The risk corridors plan-level reporting form, and instructions for 
completing the form were published as part of the information 
collection approved under OMB control number 0938-1164. In Sec. Sec.  
153.530 and 153.540 we set forth a data validation process for risk 
corridors data submissions. The information collection burden 
associated with the risk corridors data validation process is accounted 
for in the ``Supporting Statement for Paperwork Reduction Act 
Submissions: Standards Related to Reinsurance, Risk Corridors, Risk 
Adjustment, and Appeals'' approved under OMB control number 0938-1155.
    Based on CMS's identification of more significant data 
discrepancies than previously anticipated, we are requesting an 
emergency revision to the risk corridors data validation information 
collection requirement. We are requiring all companies with QHP issuers 
to complete a checklist to attest that their submission complied with 
critical guidelines for risk corridors and MLR data submission. For 
companies with issuers whose reported claims or premium amounts for 
risk corridors and MLR differ from data collected for other premium 
stabilization programs by a greater magnitude than expected, CMS is 
requiring that issuers quantify these differences, and provide a 
written explanation of the magnitude of the discrepancy. We require 
these descriptions to be approved by an actuary. The MLR Risk Corridors 
Submission Checklist and the Risk Corridors Data Discrepancy Worksheet 
will be submitted via web form at the company level, such that a 
company will submit one checklist and one discrepancy worksheet that 
includes information for all of its applicable issuers. As a result of 
this new requirement, we are updating our annual burden hour estimates 
to reflect the actual numbers of risk corridors submissions received by 
QHP issuers and the increased annual burden hours associated with 
submitting additional data validation information to CMS. Form Number: 
CMS-10401 (OMB control number: 0938-1155); Frequency: Annual; Affected 
Public: Health insurance companies that issued qualified health plans; 
Number of Respondents: 250; Total Annual Responses: 250; Total Annual 
Hours: 2,040. (For policy questions regarding this collection contact 
Jaya Ghildiyal at 301-492-5149).
    We are requesting OMB review and approval of this collection by 
September 4, 2015, with a 180-day approval period. Written comments and 
recommendations will be considered from the public if received by the 
date and address noted above.

    Dated: August 26, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2015-21476 Filed 8-27-15; 4:15 pm]
BILLING CODE 4120-01-P