81_FR_20711 81 FR 20643 - Agency Information Collection Activities: Proposed Collection; Comment Request

81 FR 20643 - Agency Information Collection Activities: Proposed Collection; Comment Request

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

Federal Register Volume 81, Issue 68 (April 8, 2016)

Page Range20643-20646
FR Document2016-08106

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 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.

Federal Register, Volume 81 Issue 68 (Friday, April 8, 2016)
[Federal Register Volume 81, Number 68 (Friday, April 8, 2016)]
[Notices]
[Pages 20643-20646]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-08106]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-317, CMS-319, CMS-10166, CMS-10178, and CMS-
10184]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services.

[[Page 20644]]


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 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.

DATES: Comments must be received by June 7, 2016.

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: 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' 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:

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-317 State Medicaid Eligibility Quality Control Sampling Plan
CMS-319 State Medicaid Eligibility Quality Control Sample Selection 
Lists
CMS-10166 Payment Error Rate Measurement in Medicaid and the State 
Children's Health Insurance Program
CMS-10178 Medicaid and State Children's Health Insurance Plan (SCHIP) 
Managed Care
CMS-10184 Payment Error Rate Measurement--State Medicaid and SCHIP 
Eligibility

    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.
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: State Medicaid 
Eligibility Quality Control (MEQC) Sample Plans; Use: The Medicaid 
Eligibility Quality Control (MEQC) system is based on monthly State 
reviews of Medicaid and Medicaid expansion under Title XXI cases by 
States performing the traditional sampling process identified through 
statistically reliable statewide samples of cases selected from the 
eligibility files. These reviews are conducted to determine whether or 
not the sampled cases meet applicable State Title XIX or XXI 
eligibility requirements when applicable. The reviews are also used to 
assess beneficiary liability, if any, and to determine the amounts paid 
to provide Medicaid services for these cases. In the MEQC system, 
sampling is the only practical method of validating eligibility of the 
total caseload and determining the dollar value of eligibility 
liability errors. Any attempt to make such validations and 
determinations by reviewing every case would be an enormous and 
unwieldy undertaking. In 1993, CMS implemented MEQC pilots in which 
States could focus on special studies, targeted populations, geographic 
areas or other forms of oversight with CMS approval. States must submit 
a sampling plan, or pilot proposal to be approved by CMS before 
implementing their pilot program. The Children's Health Insurance 
Program Reauthorization Act (CHIPRA) was enacted February 4, 2009. 
Sections 203 and 601 of the CHIPRA relate to MEQC. Section 203 of the 
CHIPRA establishes an error rate measurement with respect to the 
enrollment of children under the express lane eligibility option. The 
law directs States not to include children enrolled using the express 
lane eligibility option in data or samples used for purposes of 
complying with the MEQC requirements. Section 601 of the CHIPRA, among 
other things, requires a new final rule for the Payment Error Rate 
Measurement (PERM) program and aims to harmonize the PERM and MEQC 
programs and provides States with the option to apply PERM data 
resulting from its eligibility reviews for meeting MEQC requirements 
and vice versa, with certain conditions. We review, either directly or 
through its contractors, of the sampling plans helps to ensure States 
are using valid statistical methods for sample selection. The 
collection of information is also necessary to implement provisions 
from the Children's Health Insurance Program Reauthorization Act of 
2009 (CHIPRA) (Pub. L. 111-3) with regard to the Medicaid Eligibility 
Quality Control (MEQC) and Payment Error Rate Measurement (PERM) 
programs. Form Number: CMS-317 (OMB control number: 0938-0146); 
Frequency: Semi-Annually Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 10; Total Annual Responses: 20; 
Total Annual Hours: 480. (For policy questions regarding this 
collection contact Bridgett Rider at 410-786-2602.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of

[[Page 20645]]

Information Collection: State Medicaid Eligibility Quality Control 
(MEQC) Sample Selection Lists; Use: The MEQC system is based on monthly 
State reviews of Medicaid and Medicaid expansion under Title XXI cases 
by States performing the traditional sampling process identified 
through statistically reliable statewide samples of cases selected from 
the eligibility files. These reviews are conducted to determine whether 
or not the sampled cases meet applicable State Title XIX or XXI 
eligibility requirements when applicable. The reviews are also used to 
assess beneficiary liability, if any, and to determine the amounts paid 
to provide Medicaid services for these cases. In the MEQC system, 
sampling is the only practical method of validating eligibility of the 
total caseload and determining the dollar value of eligibility 
liability errors. Any attempt to make such validations and 
determinations by reviewing every case would be an enormous and 
unwieldy undertaking. At the beginning of each month, State agencies 
still performing the traditional sample are required to submit sample 
selection lists which identify all of the cases selected for review in 
the States' samples. The sample selection lists contain identifying 
information on Medicaid beneficiaries such as: State agency review 
number, beneficiary's name and address, the name of the county where 
the beneficiary resides, Medicaid case number, etc. The submittal of 
the sample selection lists is necessary for Regional Office validation 
of State reviews. Without these lists, the integrity of the sampling 
results would be suspect and the Regional Offices would have no data on 
the adequacy of the States' monthly sample draw or review completion 
status. The authority for collecting this information is Section 
1903(u) of the Social Security Act. The specific requirement for 
submitting sample selection lists is described in regulations at 42 CFR 
431.814(h). Regional Office staff review the sample selection lists to 
determine that States are sampling a sufficient number of cases for 
review. Form Number: CMS-319 (OMB control number: 0938-0147); 
Frequency: Monthly; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 10; Total Annual Responses: 120; 
Total Annual Hours: 960. (For policy questions regarding this 
collection contact Bridgett Rider at 410-786-2602.)
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Payment Error 
Rate Measurement in Medicaid & Children's Health Insurance Program 
(CHIP); Use: The Improper Payments Information Act (IPIA) of 2002 as 
amended by the Improper Payments Elimination and Recovery Improvement 
Act (IPERIA) of 2012 requires CMS to produce national error rates for 
Medicaid and Children's Health Insurance Program (CHIP). To comply with 
the IPIA, CMS will engage a Federal contractor to produce the error 
rates in Medicaid and CHIP. The error rates for Medicaid and CHIP are 
calculated based on the reviews on three components of both Medicaid 
and CHIP program. They are: Fee-for-service claims medical reviews and 
data processing reviews, managed care claims data-processing reviews, 
and eligibility reviews. Each of the review components collects 
different types of information, and the state-specific error rates for 
each of the review components will be used to calculate an overall 
state-specific error rate, and the individual state-specific error 
rates will be used to produce a national error rate for Medicaid and 
CHIP. The states will be requested to submit, at their option, test 
data which include full claims details to the contractor prior to the 
quarterly submissions to detect potential problems in the dataset to 
and ensure the quality of the data. These states will be required to 
submit quarterly claims data to the contractor who will pull a 
statistically valid random sample, each quarter, by strata, so that 
medical and data processing reviews can be performed. State-specific 
error rates will be based on these review results. We need to collect 
the fee-for-service claims data, medical policies, and other 
information from states as well as medical records from providers in 
order for the contractor to sample and review adjudicated claims in 
those states selected for medical reviews and data processing reviews. 
Based on the reviews, state-specific error rates will be calculated 
which will serve as part of the basis for calculating national Medicaid 
and CHIP error rates. Form Number: CMS-10166 (OMB control number: 0938-
0974); Frequency: Annually, Quarterly; Affected Public: State, Local, 
or Tribal Governments; Number of Respondents: 34; Total Annual 
Responses: 34; Total Annual Hours: 56,100. (For policy questions 
regarding this collection contact Bridgett Rider at 410-786-2602.)
    4. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicaid and 
Children's Health Insurance (CHIP) Managed Care Claims and Related 
Information; Use: The Payment Error Rate Measurement (PERM) program 
measures improper payments for Medicaid and the State Children's Health 
Insurance Program (SCHIP). The program was designed to comply with the 
Improper Payments Information Act (IPIA) of 2002 and the Office of 
Management and Budget (OMB) guidance. Although OMB guidance requires 
error rate measurement for SCHIP, 2009 SCHIP legislation temporarily 
suspended PERM measurement for this program and changed to Children's 
Health Insurance Program (CHIP) effective April 01, 2009. See 
Children's Health Insurance Program Reauthorization Act of 2009 
(CHIPRA) Public Law 111-3 for more details. There are two phases of the 
PERM program, the measurement phase and the corrective action phase. 
The PERM measures improper payments in Medicaid and CHIP and produces 
State and national-level error rates for each program. The error rates 
are based on reviews of Medicaid and CHIP fee-for-service (FFS) and 
managed care payments made in the Federal fiscal year under review. 
States conduct eligibility reviews and report eligibility related 
payment error rates also used in the national error rate calculation. 
We created a 17 State rotation cycle so that each State will 
participate in PERM once every three years. Following is the list of 
States in which we will measure improper payments over the next three 
years in Medicaid. We need to collect capitation payment information 
from the selected States so that the federal contractor can draw a 
sample and review the managed care capitation payments. We will also 
collect State managed care contracts, rate schedules and updates to the 
contracts and rate schedules. This information will be used by the 
Federal contractor when conducting the managed care claims reviews. 
Sections 1902(a)(6) and 2107(b)(1) of the Social Security Act grants 
CMS authority to collect information from the States. The IPIA requires 
us to produce national error rates in Medicaid and CHIP fee-for-
service, including the managed care component. The State-specific 
Medicaid managed care and CHIP managed care error rates will be based 
on reviews of managed care capitation payments in each program and will 
be used to produce national Medicaid managed care and CHIP managed care 
error rates. Form Number: CMS-10178 (OMB control number: 0938-0994); 
Frequency: Occasionally;  Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 34; Total Annual

[[Page 20646]]

Responses: 28,050; Total Annual Hours: 28,050. (For policy questions 
regarding this collection contact Bridgett Rider at 410-786-2602.)
    5. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Eligibility Error 
Rate Measurement in Medicaid and the Children's Health Insurance 
Program; Use: The Improper Payments Information Act (IPIA) of 2002 
requires CMS to produce national error rates for Medicaid and the 
Children's Health Insurance Program (CHIP). To comply with the IPIA, 
CMS will use a national contracting strategy to produce error rates for 
Medicaid and CHIP fee-for-service and managed care improper payments. 
The federal contractor will review States on a rotational basis so that 
each State will be measured for improper payments, in each program, 
once and only once every three years. Subsequent to the first 
publication, we determined that we will measure Medicaid and CHIP in 
the same State. Therefore, States will measure Medicaid and CHIP 
eligibility in the same year measured for fee-for-service and managed 
care. We believe this approach will advantage States through economies 
of scale (e.g. administrative ease and shared staffing for both 
programs reviews). We also determined that interim case completion 
timeframes and reporting are critical to the integrity of the reviews 
and to keep the reviews on schedule to produce a timely error rate. 
Lastly, the sample sizes were increased slightly in order to produce an 
equal sample size per strata each month. Periodically, CMS will conduct 
Federal re-reviews of States' PERM files to ensure the accuracy of 
States' review findings and the validity of the review process. CMS 
will select a random subsample of Medicaid and CHIP cases from the 
sample selection lists provided by each State. States will submit all 
pertinent information related to the review of each sampled case that 
is selected by CMS. Form Number: CMS-10184 (OMB control number: 0938-
1012); Frequency: Annually, Quarterly Affected Public: State, Local, or 
Tribal Governments; Number of Respondents: 34; Total Annual Responses: 
1,583; Total Annual Hours: 946,164. (For policy questions regarding 
this collection contact Bridgett Rider at 410-786-2602.)

    Dated: April 5, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2016-08106 Filed 4-7-16; 8:45 am]
 BILLING CODE 4120-01-P



                                                                                    Federal Register / Vol. 81, No. 68 / Friday, April 8, 2016 / Notices                                                20643

                                                  that increase the probability of a patient              National Library of Medicine, Office of               reduce the burden on health care
                                                  safety event.                                           the National Coordinator for Health                   providers and to facilitate data
                                                     AHRQ’s Common Formats for patient                    Information Technology, Office of                     transmission. These formats have two
                                                  safety event reporting include:                         Public Health and Science, and                        tiers, or data sets. The first tier, or
                                                     • Event descriptions (definitions of                 Substance Abuse and Mental Health                     national data set, contains elements that
                                                  patient safety events, near misses, and                 Services Administration—as well as the                are collected for submission to the
                                                  unsafe conditions to be reported);                      DoD and VA.                                           PSOPPC. The second tier, or local data
                                                     • Specifications for patient safety                     When developing Common Formats,                    set, is optional and is designed for use
                                                  aggregate reports and individual event                  AHRQ first reviews existing patient                   at the local level for additional analyses.
                                                  summaries that derive from event                        safety practices and event reporting                  This local data set is not meant for
                                                  descriptions;                                           systems. In collaboration with the                    transmission to the PSOPPC.
                                                     • Delineation of data elements and                   PSWG and Federal subject matter                          The Agency is specifically interested
                                                  algorithms to be used for collection of                 experts, AHRQ drafts and releases beta                in obtaining feedback from both the
                                                  adverse event data to populate the                      versions and updates to current versions              private and public sectors on the
                                                  reports; and                                            of the Common Formats for public                      updated Common Formats for Event
                                                     • Technical specifications for                       review and comment. The prior version                 Reporting—Hospitals Version 2.0. At
                                                  electronic data collection and reporting.               of Common Formats for Event Reporting                 this time, only the event descriptions—
                                                     The technical specifications promote                 for Hospitals, Version 1.2, was released              which define adverse events of interest
                                                  standardization of collected patient                    in April 2013. The PSWG assists AHRQ                  in the inpatient hospital setting—are
                                                  safety event information by specifying                  with assuring the consistency of                      available. Other elements of the
                                                  rules for data collection and submission,               definitions/formats with those of                     Common Formats, including aggregate
                                                  as well as by providing guidance for                    relevant government agencies as                       reports and technical specifications,
                                                  how and when to create data elements,                   refinement of the Common Formats                      will be developed following revision of
                                                  their valid values, conditional and go-to               continues.                                            the Common Formats for Hospital
                                                  logic, and reports. These specifications                   Since the initial release of the                   Version 2.0 based on public comment
                                                  will ensure that data collected by PSOs                 Common Formats in August 2008,                        and NQF advice. Information on how to
                                                  and other entities have comparable                      AHRQ has regularly revised the formats                comment and provide feedback on the
                                                  clinical meaning. They also provide                     based upon public comment. AHRQ                       Common Formats for Hospital Version
                                                  direction to software developers, so that               solicits feedback on beta, and                        2.0 is available at the NQF Web site:
                                                  the formats can be implemented                          subsequent, versions of Common                        http://www.qualityforum.org/Project_
                                                  electronically, and to PSOs, so that the                Formats from private sector                           Pages/Common_Formats_for_Patient_
                                                  Common Formats can be submitted                         organizations and individuals. Based                  Safety_Data.aspx.
                                                  electronically to the PSO Privacy                       upon the feedback received, AHRQ
                                                                                                                                                                   AHRQ appreciates the time and effort
                                                  Protection Center (PSOPPC) for data de-                 further revises the formats. To the extent
                                                                                                                                                                individuals invest in providing
                                                  identification and transmission to the                  practicable, the Common Formats are
                                                                                                                                                                comments. The Agency will review and
                                                  Network of Patient Safety Databases                     also aligned with World Health
                                                                                                                                                                consider all feedback received to help
                                                  (NPSD).                                                 Organization (WHO) concepts,
                                                                                                                                                                guide the development of a revised
                                                                                                          frameworks, and definitions.
                                                  Common Formats Development                                 Participation by the private sector in             version. The process for updating and
                                                     In anticipation of the need for                      the development and subsequent                        refining the formats will continue to be
                                                  Common Formats, AHRQ began their                        revision of the Common Formats is                     an iterative one.
                                                  development by creating an inventory of                 achieved through working with the                        Further information on the Common
                                                  functioning private and public sector                   NQF. The Agency engages the NQF, a                    Formats can be obtained through
                                                  patient safety reporting systems. This                  non-profit organization focused on                    AHRQ’s PSO Web site: http://
                                                  inventory provided an evidence base to                  health care quality, to solicit comments              www.pso.ahrq.gov/. To receive
                                                  inform construction of the Common                       and advice regarding proposed versions                notifications about final versions of
                                                  Formats. The inventory included many                    of the Common Formats. AHRQ began                     AHRQ Common Formats, please
                                                  systems from the private sector,                        this process with the NQF in 2008,                    subscribe to ‘‘E-Mail Updates’’ at:
                                                  including prominent academic settings,                  receiving feedback on AHRQ’s 0.1 Beta                 https://pso.ahrq.gov/about/subscribe.
                                                  hospital systems, and international                     release of the Common Formats for                     Sharon B. Arnold,
                                                  reporting systems (e.g., from the United                Event Reporting—Hospital. After                       Acting Director.
                                                  Kingdom and the Commonwealth of                         receiving public comment, the NQF                     [FR Doc. 2016–08021 Filed 4–7–16; 8:45 am]
                                                  Australia). In addition, virtually all                  solicits the review and advice of its                 BILLING CODE 4160–90–P
                                                  major Federal patient safety reporting                  Common Formats Expert Panel and
                                                  systems were included, such as those                    subsequently provides feedback to
                                                  from the Centers for Disease Control and                AHRQ. The Agency then revises and                     DEPARTMENT OF HEALTH AND
                                                  Prevention (CDC), the Food and Drug                     refines the Common Formats and issues                 HUMAN SERVICES
                                                  Administration (FDA), the Department                    them as a production version. AHRQ
                                                  of Defense (DoD), and the Department of                 has continued to employ this process for              Centers for Medicare & Medicaid
                                                  Veterans Affairs (VA).                                  all subsequent versions of the formats.               Services
                                                     Since February 2005, AHRQ has
                                                                                                          Commenting on Common Formats for                      [Document Identifier: CMS–317, CMS–319,
mstockstill on DSK4VPTVN1PROD with NOTICES




                                                  convened the PSWG to assist AHRQ
                                                  with developing and maintaining the                     Event Reporting—Hospital Version 2.0                  CMS–10166, CMS–10178, and CMS–10184]
                                                  Common Formats. The PSWG includes                         AHRQ used a tiered approach to                      Agency Information Collection
                                                  major health agencies within HHS—                       develop Hospital Version 2.0. This                    Activities: Proposed Collection;
                                                  CDC, Centers for Medicare & Medicaid                    approach was done in response to                      Comment Request
                                                  Services, FDA, Health Resources and                     feedback from PSOs and the public to
                                                  Services Administration, Indian Health                  decrease the number of questions for                  AGENCY: Centers for Medicare &
                                                  Service, National Institutes of Health,                 each module of the formats in order to                Medicaid Services.


                                             VerDate Sep<11>2014   17:48 Apr 07, 2016   Jkt 238001   PO 00000   Frm 00038   Fmt 4703   Sfmt 4703   E:\FR\FM\08APN1.SGM   08APN1


                                                  20644                             Federal Register / Vol. 81, No. 68 / Friday, April 8, 2016 / Notices

                                                  ACTION:   Notice.                                         3. Call the Reports Clearance Office at             cases meet applicable State Title XIX or
                                                                                                          (410) 786–1326.                                       XXI eligibility requirements when
                                                  SUMMARY:   The Centers for Medicare &                   FOR FURTHER INFORMATION CONTACT:                      applicable. The reviews are also used to
                                                  Medicaid Services (CMS) is announcing                   Reports Clearance Office at (410) 786–                assess beneficiary liability, if any, and to
                                                  an opportunity for the public to                        1326.                                                 determine the amounts paid to provide
                                                  comment on CMS’ intention to collect                                                                          Medicaid services for these cases. In the
                                                  information from the public. Under the                  SUPPLEMENTARY INFORMATION:
                                                                                                                                                                MEQC system, sampling is the only
                                                  Paperwork Reduction Act of 1995 (the                    Contents                                              practical method of validating eligibility
                                                  PRA), federal agencies are required to                                                                        of the total caseload and determining
                                                  publish notice in the Federal Register                     This notice sets out a summary of the
                                                                                                          use and burden associated with the                    the dollar value of eligibility liability
                                                  concerning each proposed collection of                                                                        errors. Any attempt to make such
                                                  information (including each proposed                    following information collections. More
                                                                                                          detailed information can be found in                  validations and determinations by
                                                  extension or reinstatement of an existing                                                                     reviewing every case would be an
                                                  collection of information) and to allow                 each collection’s supporting statement
                                                                                                          and associated materials (see                         enormous and unwieldy undertaking. In
                                                  60 days for public comment on the                                                                             1993, CMS implemented MEQC pilots
                                                                                                          ADDRESSES).
                                                  proposed action. Interested persons are                                                                       in which States could focus on special
                                                  invited to send comments regarding our                  CMS–317 State Medicaid Eligibility
                                                                                                             Quality Control Sampling Plan                      studies, targeted populations,
                                                  burden estimates or any other aspect of                                                                       geographic areas or other forms of
                                                  this collection of information, including               CMS–319 State Medicaid Eligibility
                                                                                                             Quality Control Sample Selection                   oversight with CMS approval. States
                                                  any of the following subjects: (1) The                                                                        must submit a sampling plan, or pilot
                                                  necessity and utility of the proposed                      Lists
                                                                                                          CMS–10166 Payment Error Rate                          proposal to be approved by CMS before
                                                  information collection for the proper                                                                         implementing their pilot program. The
                                                  performance of the agency’s functions;                     Measurement in Medicaid and the
                                                                                                             State Children’s Health Insurance                  Children’s Health Insurance Program
                                                  (2) the accuracy of the estimated                                                                             Reauthorization Act (CHIPRA) was
                                                  burden; (3) ways to enhance the quality,                   Program
                                                                                                          CMS–10178 Medicaid and State                          enacted February 4, 2009. Sections 203
                                                  utility, and clarity of the information to                                                                    and 601 of the CHIPRA relate to MEQC.
                                                                                                             Children’s Health Insurance Plan
                                                  be collected; and (4) the use of                                                                              Section 203 of the CHIPRA establishes
                                                                                                             (SCHIP) Managed Care
                                                  automated collection techniques or                      CMS–10184 Payment Error Rate                          an error rate measurement with respect
                                                  other forms of information technology to                   Measurement—State Medicaid and                     to the enrollment of children under the
                                                  minimize the information collection                        SCHIP Eligibility                                  express lane eligibility option. The law
                                                  burden.                                                                                                       directs States not to include children
                                                                                                             Under the PRA (44 U.S.C. 3501–
                                                  DATES:  Comments must be received by                    3520), federal agencies must obtain                   enrolled using the express lane
                                                  June 7, 2016.                                           approval from the Office of Management                eligibility option in data or samples
                                                  ADDRESSES: When commenting, please                      and Budget (OMB) for each collection of               used for purposes of complying with the
                                                  reference the document identifier or                    information they conduct or sponsor.                  MEQC requirements. Section 601 of the
                                                  OMB control number. To be assured                       The term ‘‘collection of information’’ is             CHIPRA, among other things, requires a
                                                  consideration, comments and                             defined in 44 U.S.C. 3502(3) and 5 CFR                new final rule for the Payment Error
                                                  recommendations must be submitted in                    1320.3(c) and includes agency requests                Rate Measurement (PERM) program and
                                                  any one of the following ways:                          or requirements that members of the                   aims to harmonize the PERM and MEQC
                                                    1. Electronically. You may send your                  public submit reports, keep records, or               programs and provides States with the
                                                  comments electronically to http://                      provide information to a third party.                 option to apply PERM data resulting
                                                  www.regulations.gov. Follow the                         Section 3506(c)(2)(A) of the PRA                      from its eligibility reviews for meeting
                                                  instructions for ‘‘Comment or                           requires federal agencies to publish a                MEQC requirements and vice versa,
                                                  Submission’’ or ‘‘More Search Options’’                 60-day notice in the Federal Register                 with certain conditions. We review,
                                                  to find the information collection                      concerning each proposed collection of                either directly or through its contractors,
                                                  document(s) that are accepting                          information, including each proposed                  of the sampling plans helps to ensure
                                                  comments.                                               extension or reinstatement of an existing             States are using valid statistical methods
                                                    2. By regular mail. You may mail                      collection of information, before                     for sample selection. The collection of
                                                  written comments to the following                       submitting the collection to OMB for                  information is also necessary to
                                                  address: CMS, Office of Strategic                       approval. To comply with this                         implement provisions from the
                                                  Operations and Regulatory Affairs,                      requirement, CMS is publishing this                   Children’s Health Insurance Program
                                                  Division of Regulations Development,                    notice.                                               Reauthorization Act of 2009 (CHIPRA)
                                                  Attention: Document Identifier/OMB                         1. Type of Information Collection                  (Pub. L. 111–3) with regard to the
                                                  Control Number ___, Room C4–26–05,                      Request: Extension of a currently                     Medicaid Eligibility Quality Control
                                                  7500 Security Boulevard, Baltimore,                     approved collection; Title of                         (MEQC) and Payment Error Rate
                                                  Maryland 21244–1850.                                    Information Collection: State Medicaid                Measurement (PERM) programs. Form
                                                    To obtain copies of a supporting                      Eligibility Quality Control (MEQC)                    Number: CMS–317 (OMB control
                                                  statement and any related forms for the                 Sample Plans; Use: The Medicaid                       number: 0938–0146); Frequency: Semi-
                                                  proposed collection(s) summarized in                    Eligibility Quality Control (MEQC)                    Annually Affected Public: State, Local,
                                                  this notice, you may make your request                  system is based on monthly State                      or Tribal Governments; Number of
                                                                                                                                                                Respondents: 10; Total Annual
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                                                  using one of following:                                 reviews of Medicaid and Medicaid
                                                    1. Access CMS’ Web site address at                    expansion under Title XXI cases by                    Responses: 20; Total Annual Hours:
                                                  http://www.cms.hhs.gov/Paperwork                        States performing the traditional                     480. (For policy questions regarding this
                                                  ReductionActof1995.                                     sampling process identified through                   collection contact Bridgett Rider at 410–
                                                    2. Email your request, including your                 statistically reliable statewide samples              786–2602.)
                                                  address, phone number, OMB number,                      of cases selected from the eligibility                   2. Type of Information Collection
                                                  and CMS document identifier, to                         files. These reviews are conducted to                 Request: Extension of a currently
                                                  Paperwork@cms.hhs.gov.                                  determine whether or not the sampled                  approved collection; Title of


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                                                                                    Federal Register / Vol. 81, No. 68 / Friday, April 8, 2016 / Notices                                          20645

                                                  Information Collection: State Medicaid                  Children’s Health Insurance Program                   Information; Use: The Payment Error
                                                  Eligibility Quality Control (MEQC)                      (CHIP); Use: The Improper Payments                    Rate Measurement (PERM) program
                                                  Sample Selection Lists; Use: The MEQC                   Information Act (IPIA) of 2002 as                     measures improper payments for
                                                  system is based on monthly State                        amended by the Improper Payments                      Medicaid and the State Children’s
                                                  reviews of Medicaid and Medicaid                        Elimination and Recovery Improvement                  Health Insurance Program (SCHIP). The
                                                  expansion under Title XXI cases by                      Act (IPERIA) of 2012 requires CMS to                  program was designed to comply with
                                                  States performing the traditional                       produce national error rates for                      the Improper Payments Information Act
                                                  sampling process identified through                     Medicaid and Children’s Health                        (IPIA) of 2002 and the Office of
                                                  statistically reliable statewide samples                Insurance Program (CHIP). To comply                   Management and Budget (OMB)
                                                  of cases selected from the eligibility                  with the IPIA, CMS will engage a                      guidance. Although OMB guidance
                                                  files. These reviews are conducted to                   Federal contractor to produce the error               requires error rate measurement for
                                                  determine whether or not the sampled                    rates in Medicaid and CHIP. The error                 SCHIP, 2009 SCHIP legislation
                                                  cases meet applicable State Title XIX or                rates for Medicaid and CHIP are                       temporarily suspended PERM
                                                  XXI eligibility requirements when                       calculated based on the reviews on three              measurement for this program and
                                                  applicable. The reviews are also used to                components of both Medicaid and CHIP                  changed to Children’s Health Insurance
                                                  assess beneficiary liability, if any, and to            program. They are: Fee-for-service                    Program (CHIP) effective April 01, 2009.
                                                  determine the amounts paid to provide                   claims medical reviews and data                       See Children’s Health Insurance
                                                  Medicaid services for these cases. In the               processing reviews, managed care                      Program Reauthorization Act of 2009
                                                  MEQC system, sampling is the only                       claims data-processing reviews, and                   (CHIPRA) Public Law 111–3 for more
                                                  practical method of validating eligibility              eligibility reviews. Each of the review               details. There are two phases of the
                                                  of the total caseload and determining                   components collects different types of                PERM program, the measurement phase
                                                  the dollar value of eligibility liability               information, and the state-specific error             and the corrective action phase. The
                                                  errors. Any attempt to make such                        rates for each of the review components               PERM measures improper payments in
                                                  validations and determinations by                       will be used to calculate an overall                  Medicaid and CHIP and produces State
                                                  reviewing every case would be an                        state-specific error rate, and the                    and national-level error rates for each
                                                  enormous and unwieldy undertaking.                      individual state-specific error rates will            program. The error rates are based on
                                                  At the beginning of each month, State                   be used to produce a national error rate              reviews of Medicaid and CHIP fee-for-
                                                  agencies still performing the traditional               for Medicaid and CHIP. The states will                service (FFS) and managed care
                                                  sample are required to submit sample                    be requested to submit, at their option,              payments made in the Federal fiscal
                                                  selection lists which identify all of the               test data which include full claims                   year under review. States conduct
                                                  cases selected for review in the States’                details to the contractor prior to the                eligibility reviews and report eligibility
                                                  samples. The sample selection lists                     quarterly submissions to detect                       related payment error rates also used in
                                                  contain identifying information on                      potential problems in the dataset to and              the national error rate calculation. We
                                                  Medicaid beneficiaries such as: State                   ensure the quality of the data. These                 created a 17 State rotation cycle so that
                                                  agency review number, beneficiary’s                     states will be required to submit                     each State will participate in PERM
                                                  name and address, the name of the                       quarterly claims data to the contractor               once every three years. Following is the
                                                  county where the beneficiary resides,                   who will pull a statistically valid                   list of States in which we will measure
                                                  Medicaid case number, etc. The                          random sample, each quarter, by strata,               improper payments over the next three
                                                  submittal of the sample selection lists is              so that medical and data processing                   years in Medicaid. We need to collect
                                                  necessary for Regional Office validation                reviews can be performed. State-specific              capitation payment information from
                                                  of State reviews. Without these lists, the              error rates will be based on these review             the selected States so that the federal
                                                  integrity of the sampling results would                 results. We need to collect the fee-for-              contractor can draw a sample and
                                                  be suspect and the Regional Offices                     service claims data, medical policies,                review the managed care capitation
                                                  would have no data on the adequacy of                   and other information from states as                  payments. We will also collect State
                                                  the States’ monthly sample draw or                      well as medical records from providers                managed care contracts, rate schedules
                                                  review completion status. The authority                 in order for the contractor to sample and             and updates to the contracts and rate
                                                  for collecting this information is Section              review adjudicated claims in those                    schedules. This information will be
                                                  1903(u) of the Social Security Act. The                 states selected for medical reviews and               used by the Federal contractor when
                                                  specific requirement for submitting                     data processing reviews. Based on the                 conducting the managed care claims
                                                  sample selection lists is described in                  reviews, state-specific error rates will be           reviews. Sections 1902(a)(6) and
                                                  regulations at 42 CFR 431.814(h).                       calculated which will serve as part of                2107(b)(1) of the Social Security Act
                                                  Regional Office staff review the sample                 the basis for calculating national                    grants CMS authority to collect
                                                  selection lists to determine that States                Medicaid and CHIP error rates. Form                   information from the States. The IPIA
                                                  are sampling a sufficient number of                     Number: CMS–10166 (OMB control                        requires us to produce national error
                                                  cases for review. Form Number: CMS–                     number: 0938–0974); Frequency:                        rates in Medicaid and CHIP fee-for-
                                                  319 (OMB control number: 0938–0147);                    Annually, Quarterly; Affected Public:                 service, including the managed care
                                                  Frequency: Monthly; Affected Public:                    State, Local, or Tribal Governments;                  component. The State-specific Medicaid
                                                  State, Local, or Tribal Governments;                    Number of Respondents: 34; Total                      managed care and CHIP managed care
                                                  Number of Respondents: 10; Total                        Annual Responses: 34; Total Annual                    error rates will be based on reviews of
                                                  Annual Responses: 120; Total Annual                     Hours: 56,100. (For policy questions                  managed care capitation payments in
                                                  Hours: 960. (For policy questions                       regarding this collection contact
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                                                                                                                                                                each program and will be used to
                                                  regarding this collection contact                       Bridgett Rider at 410–786–2602.)                      produce national Medicaid managed
                                                  Bridgett Rider at 410–786–2602.)                           4. Type of Information Collection                  care and CHIP managed care error rates.
                                                     3. Type of Information Collection                    Request: Extension of a currently                     Form Number: CMS–10178 (OMB
                                                  Request: Extension of a currently                       approved collection; Title of                         control number: 0938–0994); Frequency:
                                                  approved collection; Title of                           Information Collection: Medicaid and                  Occasionally; Affected Public: State,
                                                  Information Collection: Payment Error                   Children’s Health Insurance (CHIP)                    Local, or Tribal Governments; Number
                                                  Rate Measurement in Medicaid &                          Managed Care Claims and Related                       of Respondents: 34; Total Annual


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                                                  20646                                       Federal Register / Vol. 81, No. 68 / Friday, April 8, 2016 / Notices

                                                  Responses: 28,050; Total Annual Hours:                                   re-reviews of States’ PERM files to                     Services (HHS) intends to collect data
                                                  28,050. (For policy questions regarding                                  ensure the accuracy of States’ review                   on a third cohort of children and
                                                  this collection contact Bridgett Rider at                                findings and the validity of the review                 families for the National Survey of Child
                                                  410–786–2602.)                                                           process. CMS will select a random                       and Adolescent Well-Being (NSCAW).
                                                    5. Type of Information Collection                                      subsample of Medicaid and CHIP cases                    NSCAW is the only source of nationally
                                                  Request: Extension of a currently                                        from the sample selection lists provided                representative, longitudinal, firsthand
                                                  approved collection; Title of                                            by each State. States will submit all                   information about the functioning and
                                                  Information Collection: Eligibility Error                                pertinent information related to the                    well-being, service needs, and service
                                                  Rate Measurement in Medicaid and the                                     review of each sampled case that is                     utilization of children and families who
                                                  Children’s Health Insurance Program;                                     selected by CMS. Form Number: CMS–                      come to the attention of the child
                                                  Use: The Improper Payments                                               10184 (OMB control number: 0938–                        welfare system. The first two cohorts of
                                                  Information Act (IPIA) of 2002 requires                                  1012); Frequency: Annually, Quarterly                   NSCAW were collected beginning in
                                                  CMS to produce national error rates for                                  Affected Public: State, Local, or Tribal                1999 and 2008 and studied children
                                                  Medicaid and the Children’s Health                                       Governments; Number of Respondents:                     who had been the subject of
                                                  Insurance Program (CHIP). To comply                                      34; Total Annual Responses: 1,583;                      investigation by Child Protective
                                                  with the IPIA, CMS will use a national                                   Total Annual Hours: 946,164. (For                       Services. Children were sampled from
                                                  contracting strategy to produce error                                    policy questions regarding this                         child welfare agencies nationwide. The
                                                  rates for Medicaid and CHIP fee-for-                                     collection contact Bridgett Rider at 410–               proposed data collection plan for the
                                                  service and managed care improper                                        786–2602.)                                              third cohort of NSCAW includes two
                                                  payments. The federal contractor will                                       Dated: April 5, 2016.                                phases: Phase 1 includes child welfare
                                                  review States on a rotational basis so                                   William N. Parham, III,                                 agency recruitment and collection of
                                                  that each State will be measured for                                     Director, Paperwork Reduction Staff, Office             files for sampling children, and Phase 2
                                                  improper payments, in each program,                                      of Strategic Operations and Regulatory                  includes baseline data collection and an
                                                  once and only once every three years.                                    Affairs.                                                18-month follow-up data collection. The
                                                  Subsequent to the first publication, we                                  [FR Doc. 2016–08106 Filed 4–7–16; 8:45 am]              current data collection plan calls for
                                                  determined that we will measure                                          BILLING CODE 4120–01–P
                                                                                                                                                                                   selecting a new cohort of 4,565 children
                                                  Medicaid and CHIP in the same State.                                                                                             and families and repeating similar data
                                                  Therefore, States will measure Medicaid                                                                                          collection procedures as the previous
                                                  and CHIP eligibility in the same year                                    DEPARTMENT OF HEALTH AND                                two cohorts. This Notice is specific to
                                                  measured for fee-for-service and                                         HUMAN SERVICES                                          Phase 1. The overall goal is to recruit
                                                  managed care. We believe this approach                                                                                           child welfare agencies in 83 primary
                                                  will advantage States through                                            Administration for Children and                         sampling units nationwide. Child
                                                  economies of scale (e.g. administrative                                  Families                                                welfare agencies will be selected with
                                                  ease and shared staffing for both                                                                                                probability proportional to size, based
                                                  programs reviews). We also determined                                    Proposed Information Collection                         on the current distributions in the child
                                                  that interim case completion timeframes                                  Activity; Comment Request                               welfare system. Child welfare agency
                                                  and reporting are critical to the integrity                                Title: National Survey of Child and                   recruitment will include: mail, email,
                                                  of the reviews and to keep the reviews                                   Adolescent Well-Being-Third Cohort                      phone calls, and site visits with child
                                                  on schedule to produce a timely error                                    (NSCAW III): Agency Recruitment.                        welfare agency administrators.
                                                  rate. Lastly, the sample sizes were                                        OMB No.: 0970–0202.                                      Respondents: Child welfare agency
                                                  increased slightly in order to produce an                                  Description: The Administration for                   administrators and other personnel.
                                                  equal sample size per strata each month.                                 Children and Families (ACF) within the                  Data collection will take place over a 2-
                                                  Periodically, CMS will conduct Federal                                   U.S. Department of Health and Human                     year period.

                                                                                                                                     ANNUAL BURDEN ESTIMATES
                                                                                                                                                                   Annual          Number of           Average
                                                                                                                                              Total number       number of                                          Annual burden
                                                                                      Instrument                                                                                 responses per       burden hours
                                                                                                                                             of respondents     respondents                                            hours
                                                                                                                                                                                   respondent        per response
                                                                                                                                                                 (rounded)

                                                  Information package for agency administrators ..................                                        83                42                 1              .25             11
                                                  Initial visit or call with agency staff ......................................                          83                42                 1             1                42
                                                  Visit or call with agency staff explaining the sample file
                                                     process .............................................................................                83                42                 1             2                84
                                                  Agency staff monthly sample file generation and trans-
                                                     mission .............................................................................                83                42                15             1               630



                                                    Estimated Total Annual Burden                                            Copies of the proposed collection of                  identified by the title of the information
                                                  Hours: 767.                                                              information can be obtained and                         collection.
                                                    In compliance with the requirements                                    comments may be forwarded by writing                      The Department specifically requests
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                                                  of Section 3506(c)(2)(A) of the                                          to the Administration for Children and                  comments on (a) whether the proposed
                                                  Paperwork Reduction Act of 1995, the                                     Families, Office of Planning, Research                  collection of information is necessary
                                                  Administration for Children and                                          and Evaluation, 330 C Street SW.,                       for the proper performance of the
                                                  Families is soliciting public comment                                    Washington, DC 20201, Attn: OPRE                        functions of the agency, including
                                                  on the specific aspects of the                                           Reports Clearance Officer. Email                        whether the information shall have
                                                  information collection described above.                                  address: OPREinfocollection@                            practical utility; (b) the accuracy of the
                                                                                                                           acf.hhs.gov. All requests should be                     agency’s estimate of the burden of the


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Document Created: 2018-02-07 13:50:23
Document Modified: 2018-02-07 13:50:23
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesComments must be received by June 7, 2016.
ContactReports Clearance Office at (410) 786- 1326.
FR Citation81 FR 20643 

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