81_FR_47946 81 FR 47805 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

81 FR 47805 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

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

Federal Register Volume 81, Issue 141 (July 22, 2016)

Page Range47805-47807
FR Document2016-17251

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 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 141 (Friday, July 22, 2016)
[Federal Register Volume 81, Number 141 (Friday, July 22, 2016)]
[Notices]
[Pages 47805-47807]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-17251]


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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: Submission for OMB 
Review; Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is 
announcing an opportunity for the public to comment on CMS' intention 
to collect information from the public. Under the Paperwork Reduction 
Act of 1995 (PRA), federal agencies are required to publish notice in 
the Federal Register concerning each proposed collection of 
information, including each proposed extension or reinstatement of an 
existing collection of information, and to allow a second opportunity 
for public comment on the notice. Interested persons are invited to 
send comments regarding the burden estimate or any other aspect of this 
collection of information, including 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 on the collection(s) of information must be received by 
the OMB desk officer by August 22, 2016.

ADDRESSES: When commenting on the proposed information collections, 
please reference the document identifier or OMB control number. To be 
assured consideration, comments and recommendations must be received by 
the OMB desk officer via one of the following transmissions: OMB, 
Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-5806 OR Email: 
[email protected].
    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, you may make 
your request using one of following:
    1. Access CMS' 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: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. The term ``collection of 
information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and 
includes agency requests or requirements that members of the public 
submit reports, keep records, or provide information to a third party. 
Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires 
federal agencies to publish a 30-day notice in the Federal Register 
concerning each proposed collection of information, including each 
proposed extension or reinstatement of an existing collection of 
information, before submitting the collection to OMB for approval. To 
comply with this requirement, CMS is publishing this notice that 
summarizes the following proposed collection(s) of information for 
public comment:
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: State Medicaid 
Eligibility Quality Control 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.)

[[Page 47806]]

    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: State Medicaid 
Eligibility Quality Control Sample Selection Lists; 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. 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 
State Children's Health Insurance Plan (SCHIP) Managed Care; 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.

[[Page 47807]]

Form Number: CMS-10178 (OMB control number: 0938-0994); Frequency: 
Occasionally; Affected Public: State, Local, or Tribal Governments; 
Number of Respondents: 34; Total Annual 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: Payment Error 
Rate Measurement--State Medicaid and SCHIP Eligibility; 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: July 18, 2016.
Martique Jones,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 2016-17251 Filed 7-21-16; 8:45 am]
BILLING CODE 4120-01-P



                                                                              Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices                                            47805

                                             work on the contract were residents of                   ADDRESSES:   When commenting on the                   eligibility files. These reviews are
                                             a Gulf Coast state.                                      proposed information collections,                     conducted to determine whether or not
                                               (2) If the cognizant contracting officer               please reference the document identifier              the sampled cases meet applicable State
                                             confirms in writing that the contractor                  or OMB control number. To be assured                  Title XIX or XXI eligibility requirements
                                             has satisfied the requirements of section                consideration, comments and                           when applicable. The reviews are also
                                             (1) above, then subject to any applicable                recommendations must be received by                   used to assess beneficiary liability, if
                                             appropriations laws the contractor will                  the OMB desk officer via one of the                   any, and to determine the amounts paid
                                             be entitled to receive an award (’’Local                 following transmissions: OMB, Office of               to provide Medicaid services for these
                                             Hiring Incentive Award’’) equal to                       Information and Regulatory Affairs,                   cases. In the MEQC system, sampling is
                                             [percent] of the contract amount earned                  Attention: CMS Desk Officer, Fax                      the only practical method of validating
                                             during the contract’s performance                        Number: (202) 395–5806 OR Email:                      eligibility of the total caseload and
                                             period.                                                  OIRA_submission@omb.eop.gov.                          determining the dollar value of
                                                                                                        To obtain copies of a supporting                    eligibility liability errors. Any attempt
                                             Will D. Spoon,
                                                                                                      statement and any related forms for the               to make such validations and
                                             Program Analyst, Gulf Coast Ecosystem                    proposed collection(s) summarized in
                                             Restoration Council.                                                                                           determinations by reviewing every case
                                                                                                      this notice, you may make your request                would be an enormous and unwieldy
                                             [FR Doc. 2016–17328 Filed 7–21–16; 8:45 am]              using one of following:                               undertaking. In 1993, CMS
                                             BILLING CODE 6560–58–P                                     1. Access CMS’ Web site address at                  implemented MEQC pilots in which
                                                                                                      http://www.cms.hhs.gov/                               States could focus on special studies,
                                                                                                      PaperworkReductionActof1995.                          targeted populations, geographic areas
                                             DEPARTMENT OF HEALTH AND                                   2. Email your request, including your               or other forms of oversight with CMS
                                             HUMAN SERVICES                                           address, phone number, OMB number,                    approval. States must submit a sampling
                                                                                                      and CMS document identifier, to                       plan, or pilot proposal to be approved
                                             Centers for Medicare & Medicaid                          Paperwork@cms.hhs.gov.                                by CMS before implementing their pilot
                                             Services                                                   3. Call the Reports Clearance Office at             program. The Children’s Health
                                                                                                      (410) 786–1326.                                       Insurance Program Reauthorization Act
                                             [Document Identifier: CMS–317, CMS–319,                  FOR FURTHER INFORMATION CONTACT:                      (CHIPRA) was enacted February 4, 2009.
                                             CMS–10166, CMS–10178, and CMS–10184]                     Reports Clearance Office at (410) 786–                Sections 203 and 601 of the CHIPRA
                                                                                                      1326.                                                 relate to MEQC. Section 203 of the
                                             Agency Information Collection
                                             Activities: Submission for OMB                           SUPPLEMENTARY INFORMATION:      Under the             CHIPRA establishes an error rate
                                             Review; Comment Request                                  Paperwork Reduction Act of 1995 (PRA)                 measurement with respect to the
                                                                                                      (44 U.S.C. 3501–3520), federal agencies               enrollment of children under the
                                             AGENCY: Centers for Medicare &                           must obtain approval from the Office of               express lane eligibility option. The law
                                             Medicaid Services, HHS.                                  Management and Budget (OMB) for each                  directs States not to include children
                                             ACTION: Notice.                                          collection of information they conduct                enrolled using the express lane
                                                                                                      or sponsor. The term ‘‘collection of                  eligibility option in data or samples
                                             SUMMARY:    The Centers for Medicare &                   information’’ is defined in 44 U.S.C.                 used for purposes of complying with the
                                             Medicaid Services (CMS) is announcing                    3502(3) and 5 CFR 1320.3(c) and                       MEQC requirements. Section 601 of the
                                             an opportunity for the public to                         includes agency requests or                           CHIPRA, among other things, requires a
                                             comment on CMS’ intention to collect                     requirements that members of the public               new final rule for the Payment Error
                                             information from the public. Under the                   submit reports, keep records, or provide              Rate Measurement (PERM) program and
                                             Paperwork Reduction Act of 1995                          information to a third party. Section                 aims to harmonize the PERM and MEQC
                                             (PRA), federal agencies are required to                  3506(c)(2)(A) of the PRA (44 U.S.C.                   programs and provides States with the
                                             publish notice in the Federal Register                   3506(c)(2)(A)) requires federal agencies              option to apply PERM data resulting
                                             concerning each proposed collection of                   to publish a 30-day notice in the                     from its eligibility reviews for meeting
                                             information, including each proposed                     Federal Register concerning each                      MEQC requirements and vice versa,
                                             extension or reinstatement of an existing                proposed collection of information,                   with certain conditions. We review,
                                             collection of information, and to allow                  including each proposed extension or                  either directly or through its contractors,
                                             a second opportunity for public                          reinstatement of an existing collection               of the sampling plans helps to ensure
                                             comment on the notice. Interested                        of information, before submitting the                 States are using valid statistical methods
                                             persons are invited to send comments                     collection to OMB for approval. To                    for sample selection. The collection of
                                             regarding the burden estimate or any                     comply with this requirement, CMS is                  information is also necessary to
                                             other aspect of this collection of                       publishing this notice that summarizes                implement provisions from the
                                             information, including any of the                        the following proposed collection(s) of               Children’s Health Insurance Program
                                             following subjects: (1) The necessity and                information for public comment:                       Reauthorization Act of 2009 (CHIPRA)
                                             utility of the proposed information                         1. Type of Information Collection                  (Pub. L. 111–3) with regard to the
                                             collection for the proper performance of                 Request: Extension of a currently                     Medicaid Eligibility Quality Control
                                             the agency’s functions; (2) the accuracy                 approved collection; Title of                         (MEQC) and Payment Error Rate
                                             of the estimated burden; (3) ways to                     Information Collection: State Medicaid                Measurement (PERM) programs. Form
                                             enhance the quality, utility, and clarity                Eligibility Quality Control Sample                    Number: CMS–317 (OMB control
                                             of the information to be collected; and                  Plans; Use: The Medicaid Eligibility                  number: 0938–0146); Frequency: Semi-
                                             (4) the use of automated collection
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                                                                                                      Quality Control (MEQC) system is based                Annually Affected Public: State, Local,
                                             techniques or other forms of information                 on monthly State reviews of Medicaid                  or Tribal Governments; Number of
                                             technology to minimize the information                   and Medicaid expansion under Title                    Respondents: 10; Total Annual
                                             collection burden.                                       XXI cases by States performing the                    Responses: 20; Total Annual Hours:
                                             DATES: Comments on the collection(s) of                  traditional sampling process identified               480. (For policy questions regarding this
                                             information must be received by the                      through statistically reliable statewide              collection contact Bridgett Rider at 410–
                                             OMB desk officer by August 22, 2016.                     samples of cases selected from the                    786–2602.)


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                                             47806                            Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices

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


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                                                                              Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices                                              47807

                                             Form Number: CMS–10178 (OMB                                Dated: July 18, 2016.                               document(s) that are accepting
                                             control number: 0938–0994); Frequency:                   Martique Jones,                                       comments.
                                             Occasionally; Affected Public: State,                    Director, Regulations Development Group,                2. By regular mail. You may mail
                                             Local, or Tribal Governments; Number                     Office of Strategic Operations and Regulatory         written comments to the following
                                             of Respondents: 34; Total Annual                         Affairs.                                              address: CMS, Office of Strategic
                                             Responses: 28,050; Total Annual Hours:                   [FR Doc. 2016–17251 Filed 7–21–16; 8:45 am]           Operations and Regulatory Affairs,
                                             28,050. (For policy questions regarding                  BILLING CODE 4120–01–P                                Division of Regulations Development,
                                             this collection contact Bridgett Rider at                                                                      Attention: Document Identifier/OMB
                                             410–786–2602.)                                                                                                 Control Number lll, Room C4–26–
                                                                                                      DEPARTMENT OF HEALTH AND                              05, 7500 Security Boulevard, Baltimore,
                                                5. Type of Information Collection                     HUMAN SERVICES                                        Maryland 21244–1850.
                                             Request: Extension of a currently                                                                                To obtain copies of a supporting
                                             approved collection; Title of                            Centers for Medicare & Medicaid                       statement and any related forms for the
                                             Information Collection: Payment Error                    Services                                              proposed collection(s) summarized in
                                             Rate Measurement—State Medicaid and                      [Document Identifiers: CMS–R–70, CMS–R–               this notice, you may make your request
                                             SCHIP Eligibility; Use: The Improper                     72, CMS–R–247, CMS–10151, CMS–10268,                  using one of following:
                                             Payments Information Act (IPIA) of                       CMS–R–5, CMS–10615, and CMS–10062]                      1. Access CMS’ Web site address at
                                             2002 requires CMS to produce national                                                                          http://www.cms.hhs.gov/
                                             error rates for Medicaid and the                         Agency Information Collection                         PaperworkReductionActof1995.
                                             Children’s Health Insurance Program                      Activities: Proposed Collection;                        2. Email your request, including your
                                             (CHIP). To comply with the IPIA, CMS                     Comment Request                                       address, phone number, OMB number,
                                             will use a national contracting strategy                 AGENCY: Centers for Medicare &                        and CMS document identifier, to
                                             to produce error rates for Medicaid and                  Medicaid Services, HHS.                               Paperwork@cms.hhs.gov.
                                             CHIP fee-for-service and managed care                    ACTION: Notice.                                         3. Call the Reports Clearance Office at
                                             improper payments. The Federal                                                                                 (410) 786–1326.
                                             contractor will review States on a                       SUMMARY:   The Centers for Medicare &                 FOR FURTHER INFORMATION CONTACT:
                                             rotational basis so that each State will                 Medicaid Services (CMS) is announcing                 Reports Clearance Office at (410) 786–
                                             be measured for improper payments, in                    an opportunity for the public to                      1326.
                                             each program, once and only once every                   comment on CMS’ intention to collect
                                                                                                      information from the public. Under the                SUPPLEMENTARY INFORMATION:
                                             three years. Subsequent to the first
                                             publication, we determined that we will                  Paperwork Reduction Act of 1995 (the                  Contents
                                             measure Medicaid and CHIP in the same                    PRA), federal agencies are required to
                                                                                                      publish notice in the Federal Register                  This notice sets out a summary of the
                                             State. Therefore, States will measure                                                                          use and burden associated with the
                                             Medicaid and CHIP eligibility in the                     concerning each proposed collection of
                                                                                                      information (including each proposed                  following information collections. More
                                             same year measured for fee-for-service                                                                         detailed information can be found in
                                                                                                      extension or reinstatement of an existing
                                             and managed care. We believe this                                                                              each collection’s supporting statement
                                                                                                      collection of information) and to allow
                                             approach will advantage States through                                                                         and associated materials (see
                                                                                                      60 days for public comment on the
                                             economies of scale (e.g., administrative                                                                       ADDRESSES).
                                                                                                      proposed action. Interested persons are
                                             ease and shared staffing for both                                                                              CMS–R–70 Information Collection
                                                                                                      invited to send comments regarding our
                                             programs reviews). We also determined                    burden estimates or any other aspect of                Requirements in HSQ–110, Acquisition,
                                             that interim case completion timeframes                  this collection of information, including              Protection and Disclosure of Peer review
                                             and reporting are critical to the integrity              any of the following subjects: (1) The                 Organization Information and Supporting
                                             of the reviews and to keep the reviews                                                                          Regulations
                                                                                                      necessity and utility of the proposed                 CMS–R–72 Information Collection
                                             on schedule to produce a timely error                    information collection for the proper                  Requirements in 42 CFR 478.18, 478.34,
                                             rate. Lastly, the sample sizes were                      performance of the agency’s functions;                 478.36, 478.42, QIO Reconsiderations and
                                             increased slightly in order to produce an                (2) the accuracy of the estimated                      Appeals
                                             equal sample size per strata each month.                 burden; (3) ways to enhance the quality,              CMS–R–247 Expanded Coverage for
                                             Periodically, CMS will conduct Federal                   utility, and clarity of the information to             Diabetes Outpatient Self-Management
                                             re-reviews of States’ PERM files to                      be collected; and (4) the use of                       Training Services and Supporting
                                             ensure the accuracy of States’ review                    automated collection techniques or                     Regulations
                                             findings and the validity of the review                                                                        CMS–10151 Data Collection for Medicare
                                                                                                      other forms of information technology to
                                                                                                                                                             Beneficiaries Receiving Implantable
                                             process. CMS will select a random                        minimize the information collection                    Cardioverter-Defibrillators for Primary
                                             subsample of Medicaid and CHIP cases                     burden.                                                Prevention of Sudden Cardiac Death
                                             from the sample selection lists provided                 DATES: Comments must be received by                   CMS–10268 Consolidated Renal Operations
                                             by each State. States will submit all                    September 20, 2016.                                    in a Web Enabled Network (CROWNWeb)
                                             pertinent information related to the                                                                            Third-party Submission Authorization
                                                                                                      ADDRESSES: When commenting, please
                                             review of each sampled case that is                                                                             Form
                                                                                                      reference the document identifier or                  CMS–R–5 Physician Certification/
                                             selected by CMS. Form Number: CMS–                       OMB control number. To be assured                      Recertification in Skilled Nursing Facilities
                                             10184 (OMB control number: 0938–                         consideration, comments and                            (SNFs) Manual Instructions
                                             1012); Frequency: Annually, Quarterly                    recommendations must be submitted in                  CMS–10615 Healthy Indiana Program (HIP)
                                             Affected Public: State, Local, or Tribal
ehiers on DSK5VPTVN1PROD with NOTICES




                                                                                                      any one of the following ways:                         2.0 Beneficiaries Survey, Focus Groups,
                                             Governments; Number of Respondents:                        1. Electronically. You may send your                 and Informational Interviews
                                             34; Total Annual Responses: 1,583;                       comments electronically to http://                    CMS–10062 Collection of Diagnostic Data
                                             Total Annual Hours: 946,164. (For                        www.regulations.gov. Follow the                        from Medicare Advantage Organizations
                                             policy questions regarding this                          instructions for ‘‘Comment or                          for Risk Adjusted Payments
                                             collection contact Bridgett Rider at 410–                Submission’’ or ‘‘More Search Options’’                 Under the PRA (44 U.S.C. 3501–
                                             786–2602.)                                               to find the information collection                    3520), federal agencies must obtain


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Document Created: 2016-07-22 02:38:19
Document Modified: 2016-07-22 02:38:19
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 on the collection(s) of information must be received by the OMB desk officer by August 22, 2016.
ContactReports Clearance Office at (410) 786- 1326.
FR Citation81 FR 47805 

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