81 FR 8498 - Agency Information Collection Activities: Proposed Collection; Comment Request
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 81, Issue 33 (February 19, 2016)
Centers for Medicare & Medicaid Services
Federal Register Volume 81, Issue 33 (February 19, 2016)
| Page Range | 8498-8500 | |
| FR Document | 2016-03474 |
[Federal Register Volume 81, Number 33 (Friday, February 19, 2016)] [Notices] [Pages 8498-8500] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2016-03474] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifier: CMS-484; CMS-846-849, 854, 10125 and 10126; CMS- 10379; and CMS-10418] Agency Information Collection Activities: Proposed Collection; 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 (the PRA), federal agencies are require; 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 April 19, 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 [[Page 8499]] 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-484 Attending Physician's Certification of Medical Necessity for Home Oxygen Therapy and Supporting Regulations CMS-846-849, 854, 10125 and 10126 Durable Medical Equipment Medicare Administrative Contractors (MAC) Regional Carrier, Certificate of Medical Necessity and Supporting Documentation CMS-10379 Rate Increase Disclosure and Review Reporting Requirements CMS-10418 Medical Loss Ratio Annual Reports, MLR Notices, and Recordkeeping Requirements 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: Attending Physician's Certification of Medical Necessity for Home Oxygen Therapy and Supporting Regulations; Use: Under Section 1862(a)(1)(A) of the Social Security Act (the Act), 42 U.S.C. 1395y(a), the Secretary may only pay for items and services that are ``reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.'' In order to assure this, CMS and its contractors develop Medical policies that specify the circumstances under which an item or service can be covered. The certificate of medical necessity (CMN) provides a mechanism for suppliers of Durable Medical Equipment, defined in 42 U.S.C. 1395x (n), and Medical Equipment and Supplies defined in 42 U.S.C. 1395j(5), to demonstrate that the item being provided meets the criteria for Medicare coverage. Section 1833(e), 42 U.S.C. 1395l(e), provides that no payment can be made to any provider of services, or other person, unless that person has furnished the information necessary for Medicare or its contractor to determine the amounts due to be paid. Certain individuals can use a CMN to furnish this information, rather than having to produce large quantities of medical records for every claim they submit for payment. Under Section 1834(j)(2) of the Act, 42 U.S.C. 1395m(j)(2), suppliers of DME items are prohibited from providing medical information to physicians when a CMN is being completed to document medical necessity. The physician who orders the item is responsible for providing the information necessary to demonstrate that the item provided is reasonable and necessary and the supplier shall also list on the CMN the fee schedule amount and the suppliers charge for the medical equipment or supplies being furnished prior to distribution of such certificate to the physician. Any supplier of medical equipment who knowingly and willfully distributes a CMN in violation of this restriction is subject to penalties, including civil money penalties (42 U.S.C. 1395m (j)(2)(A)(iii)). Under Section 42 Code of Federal Regulations Sec. 410.38 and Sec. 424.5, Medicare has the legal authority to collect sufficient information to determine payment for oxygen, and oxygen equipment. Oxygen and oxygen equipment is by far the largest single total charge of all items paid under durable medical equipment coverage authority. Detailed criteria concerning coverage of home oxygen therapy are found in Medicare Carriers Manual Chapter II-- Coverage Issues Appendix, Section 60-4. For Medicare to consider any item for coverage and payment, the information submitted by the supplier (e.g., claims and CMNs), including documentation in the patient's medical records must corroborate that the patient meets Medicare coverage criteria. The patient's medical records may include: Physician's office records; hospital records; nursing home records; home health agency records; records from other healthcare professionals or test reports. This documentation must be available to the DME MACs upon request. Form Number: CMS-484 (OMB Control Number: 0938-0534); Frequency: Occasionally; Affected Public: Private Sector: Business or other for-profits, Not-for-profits; Number of Respondents: 8,880; Total Annual Responses: 1,632,000; Total Annual Hours: 326,500. (For policy questions regarding this collection contact Paula Smith at 410-786- 4709.) 2. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: Durable Medical Equipment Medicare Administrative Contractors (MAC) Regional Carrier, Certificate of Medical Necessity and Supporting Documentation; Use: The certificates of medical necessity (CMNs) collect information required to help determine the medical necessity of certain items. CMS requires CMNs where there may be a vulnerability to the Medicare program. Each initial claim for these items must have an associated CMN for the beneficiary. Suppliers (those who bill for the items) complete the administrative information (e.g., patient's name and address, items ordered, etc.) on each CMN. The 1994 Amendments to the Social Security Act require that the supplier also provide a narrative description of the items ordered and all related accessories, their charge for each of these items, and the Medicare fee schedule allowance (where applicable). The supplier then sends the CMN to the treating physician or other clinicians (e.g., physician assistant, LPN, etc.) who completes questions pertaining to the beneficiary's medical condition and signs the CMN. The physician or other clinician returns the CMN to the supplier who has the option to maintain a copy and then submits the CMN (paper or electronic) to CMS, along with a claim for reimbursement. This clearance request is for CMNs with the form numbers, CMS CMS-846- 849, 854, 10125 and 10126. Form Number: CMS-846-849, 854, 10125 and 10126 [[Page 8500]] (OMB Control Number: 0938-0679); Frequency: Occasionally; Affected Public: Individuals or Households; Number of Respondents: 462,000; Total Annual Responses: 462,000; Total Annual Hours: 418,563. (For policy questions regarding this collection contact Paula Smith at 410- 786-4709.) 3. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: Rate Increase Disclosure and Review Reporting Requirements; Use: Section 1003 of the Affordable Care Act adds a new section 2794 of the PHS Act which directs the Secretary of the Department of Health and Human Services (the Secretary), in conjunction with the states, to establish a process for the annual review of ``unreasonable increases in premiums for health insurance coverage.'' The statute provides that health insurance issuers must submit to the Secretary and the applicable state justifications for unreasonable premium increases prior to the implementation of the increases. Section 2794 also specifies that beginning with plan years beginning in 2014, the Secretary, in conjunction with the states, shall monitor premium increases of health insurance coverage offered through an Exchange and outside of an Exchange. Section 2794 directs the Secretary to ensure the public disclosure of information and justification relating to unreasonable rate increases. Section 2794 requires that health insurance issuers submit justification for an unreasonable rate increase to CMS and the relevant state prior to its implementation. Additionally, section 2794 requires that rate increases effective in 2014 (submitted for review in 2013) be monitored by the Secretary, in conjunction with the states. To those ends, Section 154 of the CFR establishes various reporting requirements for health insurance issuers, including a Preliminary Justification for a proposed rate increase, a Final Justification for any rate increase determined by a state or CMS to be unreasonable, and a notification requirement for unreasonable rate increases which the issuer will not implement. In order to obtain the information necessary to monitor premium increases of health insurance coverage offered through an Exchange and outside of an Exchange, 45 CFR 154.215 would require health insurance issuers to submit the Unified Rate Review Template for all single risk pool coverage products in the individual or small group (or merged) market, regardless of whether any plan within a product is subject to a rate increase. That regulation would also require health insurance issuers to submit an Actuarial Memorandum (in addition to the Unified Rate Review Template) when a plan within a product is subject to a rate increase. Although the two required documents are submitted at the risk pool level, the requirement to submit is based on increases at the plan level. In order to conduct a review to assess reasonableness when a plan within a product has a rate increase that is subject to review, health insurance issuers would be required to submit a written description justifying the increase (in addition to the Unified Rate Review Template and Actuarial Memorandum). Although the required documents are submitted at the risk pool level, the requirement to submit is based on increases at the plan level. Form Number: CMS-10379 (OMB Control Number: 0938-1141); Frequency: Yearly; Affected Public: State and Private sector (Business or other for-profits and Not-for-profit institutions); Number of Respondents: 1,081; Total Annual Responses: 1,621; Total Annual Hours: 17,837. (For policy questions regarding this collection contact Lisa Cuozzo at 410-786-1746.) 4. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Medical Loss Ratio Annual Reports, MLR Notices, and Recordkeeping Requirements; Use: Under Section 2718 of the Affordable Care Act and implementing regulation at 45 CFR part 158, a health insurance issuer (issuer) offering group or individual health insurance coverage must submit a report to the Secretary concerning the amount the issuer spends each year on claims, quality improvement expenses, non-claims costs, Federal and State taxes and licensing and regulatory fees, the amount of earned premium, and beginning with the 2014 reporting year, the amounts related to the transitional reinsurance, risk adjustment, and risk corridors. An issuer must provide an annual rebate if the amount it spends on certain costs compared to its premium revenue (excluding Federal and States taxes and licensing and regulatory fees) does not meet a certain ratio, referred to as the medical loss ratio (MLR). Each issuer is required to submit annually MLR data, including information about any rebates it must provide, on a form prescribed by CMS, for each State in which the issuer conducts business. Each issuer is also required to provide a rebate notice to each policyholder that is owed a rebate and each subscriber of policyholders that are owed a rebate for any given MLR reporting year. Additionally, each issuer is required to maintain for a period of seven years all documents, records and other evidence that support the data included in each issuer's annual report to the Secretary. Under Section 1342 of the Patient Protection and Affordable Care Act and implementing regulation at 45 CFR part 153, issuers of qualified health plans (QHPs) must participate in a risk corridors program. A QHP issuer is required to pay charges to or receive payments from CMS based on the ratio of the issuer's allowable costs to the target amount. Each QHP issuer is required to submit an annual report to CMS concerning the issuer's allowable costs, allowable administrative costs, and the amount of premium. The 2015 MLR Reporting Form and Instructions reflect changes for the 2015 reporting/benefit year and beyond. In 2016, it is expected that issuers will submit fewer reports and send fewer notices to policyholders and subscribers, which will reduce burden on issuers. On the other hand, it is expected that issuers will send more rebate checks in the mail to individual market policyholders, which will increase burden for some issuers. It is estimated that there will be a net reduction in total burden from 271,600 to 235,148. Form Number: CMS-10418 (OMB Control Number: 0938-1164); Frequency: Annually; Affected Public: Private Sector, Business or other for-profits and not- for-profit institutions; Number of Respondents: 538; Number of Responses: 2,818; Total Annual Hours: 235,148. (For policy questions regarding this collection contact Christina Whitefield at 301-492- 4172.) Dated: February 16, 2016. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2016-03474 Filed 2-18-16; 8:45 am] BILLING CODE 4120-01-P
![8498 Federal Register / Vol. 81, No. 33 / Friday, February 19, 2016 / Notices
explain or clarify status as a rescission notice, and patient protection DEPARTMENT OF HEALTH AND
grandfathered health plan. The plan disclosure requirements that are subject HUMAN SERVICES
must make such records available for to the Paperwork Reduction Act of 1995.
examination upon request by The enrollment opportunity notice was Centers for Medicare & Medicaid
participants, beneficiaries, individual to be used by health plans to notify Services
policy subscribers, or a State or Federal certain individuals of their right to re- [Document Identifier: CMS–484; CMS–846–
agency official. A grandfathered health enroll in their plan. This notice was a 849, 854, 10125 and 10126; CMS–10379; and
plan is also required to include a one-time requirement and has been CMS–10418]
statement in any summary of benefits discontinued. The rescission notice will
under the plan or health insurance be used by health plans to provide Agency Information Collection
coverage, that the plan or coverage advance notice to certain individuals Activities: Proposed Collection;
believes it is a grandfathered health plan that their coverage may be rescinded as Comment Request
within the meaning of section 1251 of
a result of fraud or intentional AGENCY: Centers for Medicare &
the Affordable Care Act, and providing
misrepresentation of material fact. The Medicaid Services, HHS.
contact information for participants to
direct questions and complaints. In patient protection notification will be ACTION: Notice.
addition, a grandfathered group health used by health plans to inform certain
plan that is changing health insurance individuals of their right to choose a SUMMARY: The Centers for Medicare &
issuers is required to provide the primary care provider or pediatrician Medicaid Services (CMS) is announcing
succeeding health insurance issuer (and and to use obstetrical/gynecological an opportunity for the public to
the succeeding health insurance issuer services without prior authorization. comment on CMS’ intention to collect
must require) documentation of plan information from the public. Under the
The related provisions are finalized in
terms (including benefits, cost sharing, Paperwork Reduction Act of 1995 (the
the final regulations titled ‘‘Final Rules
employer contributions, and annual PRA), federal agencies are require; to
Under the Affordable Care Act for publish notice in the Federal Register
limits) under the prior health insurance Grandfathered Plans, Preexisting
coverage sufficient to make a concerning each proposed collection of
Condition Exclusions, Lifetime and information (including each proposed
determination whether the standards of Annual Limits, Rescissions, Dependent
paragraph (g)(1) of the interim final extension or reinstatement of an existing
Coverage, Appeals, and Patient collection of information) and to allow
regulations are exceeded. It is also Protections’’. The final regulations also
required that, for an insured group 60 days for public comment on the
require that, if State law prohibits proposed action. Interested persons are
health plan (or a multiemployer plan) balance billing, or a plan or issuer is
that is a grandfathered plan, the relevant invited to send comments regarding our
contractually responsible for any burden estimates or any other aspect of
policies, certificates, or contracts of
amounts balanced billed by an out-of- this collection of information, including
insurance, or plan documents must
disclose in a prominent and effective network emergency services provider, a any of the following subjects: (1) The
manner that employers, employee plan or issuer must provide a necessity and utility of the proposed
organizations, or plan sponsors, as participant, beneficiary or enrollee information collection for the proper
applicable, are required to notify the adequate and prominent notice of their performance of the agency’s functions;
issuer (or multiemployer plan) if the lack of financial responsibility with (2) the accuracy of the estimated
contribution rate changes at any point respect to amounts balanced billed in burden; (3) ways to enhance the quality,
during the plan year. Form Number: order to prevent inadvertent payment by utility, and clarity of the information to
CMS–10325 (OMB Control Number: the individual. Form Number: CMS– be collected; and (4) the use of
0938–1093); Frequency: Occasionally; 10330 (OMB Control Number: 0938– automated collection techniques or
Affected Public: State, Local, or Tribal 1094); Frequency: Occasionally; other forms of information technology to
Governments, Private Sector; Number of Affected Public: Private Sector, State, minimize the information collection
Respondents: 55,378; Total Annual Local, or Tribal Governments; Number burden.
Responses: 6,858,135; Total Annual of Respondents: 3,171; Total Annual DATES: Comments must be received by
Hours: 248. (For policy questions Responses: 238,244; Total Annual April 19, 2016.
regarding this collection contact Russell Hours: 897. (For policy questions ADDRESSES: When commenting, please
Tipps at (301) 492–4371). regarding this collection contact Russell reference the document identifier or
2. Type of Information Collection Tipps at 301–492–4371). OMB control number. To be assured
Request: Revision of a currently Dated: February 16, 2016. consideration, comments and
approved collection; Title of recommendations must be submitted in
William N. Parham, III,
Information Collection: Enrollment any one of the following ways:
Opportunity Notice Relating to Lifetime Director, Paperwork Reduction Staff, Office 1. Electronically. You may send your
Limits; Required Notice of Rescission of of Strategic Operations and Regulatory comments electronically to http://
Coverage; and Disclosure Requirements Affairs. www.regulations.gov. Follow the
for Patient Protection Under the [FR Doc. 2016–03473 Filed 2–18–16; 8:45 am] instructions for ‘‘Comment or
Affordable Care Act; Use: Sections 2711, BILLING CODE 4120–01–P Submission’’ or ‘‘More Search Options’’
2712 and 2719A of the Public Health to find the information collection
asabaliauskas on DSK5VPTVN1PROD with NOTICES
Service Act, as added by the Affordable document(s) that are accepting
Care Act, and the interim final comments.
regulations titled ‘‘Patient Protection 2. By regular mail. You may mail
and Affordable Care Act: Preexisting written comments to the following
Condition Exclusions, Lifetime and address: CMS, Office of Strategic
Annual Limits, Rescissions, and Patient Operations and Regulatory Affairs,
Protections’’ (75 FR 37188, June 28, Division of Regulations Development,
2010) contain enrollment opportunity, Attention: Document Identifier/OMB
VerDate Sep<11>2014 17:59 Feb 18, 2016 Jkt 238001 PO 00000 Frm 00025 Fmt 4703 Sfmt 4703 E:\FR\FM\19FEN1.SGM 19FEN1](https://thefederalregister.org/doc/81_FR_8531/page/1.svg)
![8500 Federal Register / Vol. 81, No. 33 / Friday, February 19, 2016 / Notices
(OMB Control Number: 0938–0679); That regulation would also require any given MLR reporting year.
Frequency: Occasionally; Affected health insurance issuers to submit an Additionally, each issuer is required to
Public: Individuals or Households; Actuarial Memorandum (in addition to maintain for a period of seven years all
Number of Respondents: 462,000; Total the Unified Rate Review Template) documents, records and other evidence
Annual Responses: 462,000; Total when a plan within a product is subject that support the data included in each
Annual Hours: 418,563. (For policy to a rate increase. Although the two issuer’s annual report to the Secretary.
questions regarding this collection required documents are submitted at the Under Section 1342 of the Patient
contact Paula Smith at 410–786–4709.) risk pool level, the requirement to Protection and Affordable Care Act and
3. Type of Information Collection submit is based on increases at the plan implementing regulation at 45 CFR part
Request: Revision of a currently level. 153, issuers of qualified health plans
approved collection; Title of In order to conduct a review to assess (QHPs) must participate in a risk
Information Collection: Rate Increase reasonableness when a plan within a corridors program. A QHP issuer is
Disclosure and Review Reporting product has a rate increase that is required to pay charges to or receive
Requirements; Use: Section 1003 of the subject to review, health insurance payments from CMS based on the ratio
Affordable Care Act adds a new section issuers would be required to submit a of the issuer’s allowable costs to the
2794 of the PHS Act which directs the written description justifying the target amount. Each QHP issuer is
Secretary of the Department of Health increase (in addition to the Unified Rate required to submit an annual report to
and Human Services (the Secretary), in Review Template and Actuarial CMS concerning the issuer’s allowable
conjunction with the states, to establish Memorandum). Although the required costs, allowable administrative costs,
a process for the annual review of documents are submitted at the risk and the amount of premium.
‘‘unreasonable increases in premiums pool level, the requirement to submit is The 2015 MLR Reporting Form and
for health insurance coverage.’’ The based on increases at the plan level. Instructions reflect changes for the 2015
statute provides that health insurance Form Number: CMS–10379 (OMB reporting/benefit year and beyond. In
issuers must submit to the Secretary and Control Number: 0938–1141); 2016, it is expected that issuers will
the applicable state justifications for Frequency: Yearly; Affected Public: submit fewer reports and send fewer
unreasonable premium increases prior State and Private sector (Business or notices to policyholders and
to the implementation of the increases. other for-profits and Not-for-profit subscribers, which will reduce burden
Section 2794 also specifies that institutions); Number of Respondents: on issuers. On the other hand, it is
beginning with plan years beginning in 1,081; Total Annual Responses: 1,621; expected that issuers will send more
2014, the Secretary, in conjunction with Total Annual Hours: 17,837. (For policy rebate checks in the mail to individual
the states, shall monitor premium questions regarding this collection market policyholders, which will
increases of health insurance coverage contact Lisa Cuozzo at 410–786–1746.) increase burden for some issuers. It is
offered through an Exchange and 4. Type of Information Collection estimated that there will be a net
outside of an Exchange. Request: Extension of a currently reduction in total burden from 271,600
Section 2794 directs the Secretary to approved collection; Title of to 235,148. Form Number: CMS–10418
ensure the public disclosure of Information Collection: Medical Loss (OMB Control Number: 0938–1164);
information and justification relating to Ratio Annual Reports, MLR Notices, and Frequency: Annually; Affected Public:
unreasonable rate increases. Section Recordkeeping Requirements; Use: Private Sector, Business or other for-
2794 requires that health insurance Under Section 2718 of the Affordable profits and not-for-profit institutions;
issuers submit justification for an Care Act and implementing regulation Number of Respondents: 538; Number
unreasonable rate increase to CMS and at 45 CFR part 158, a health insurance
of Responses: 2,818; Total Annual
the relevant state prior to its issuer (issuer) offering group or
Hours: 235,148. (For policy questions
implementation. Additionally, section individual health insurance coverage
regarding this collection contact
2794 requires that rate increases must submit a report to the Secretary
Christina Whitefield at 301–492–4172.)
effective in 2014 (submitted for review concerning the amount the issuer
in 2013) be monitored by the Secretary, spends each year on claims, quality Dated: February 16, 2016.
in conjunction with the states. To those improvement expenses, non-claims William N. Parham, III,
ends, Section 154 of the CFR establishes costs, Federal and State taxes and Director, Paperwork Reduction Staff, Office
various reporting requirements for licensing and regulatory fees, the of Strategic Operations and Regulatory
health insurance issuers, including a amount of earned premium, and Affairs.
Preliminary Justification for a proposed beginning with the 2014 reporting year, [FR Doc. 2016–03474 Filed 2–18–16; 8:45 am]
rate increase, a Final Justification for the amounts related to the transitional BILLING CODE 4120–01–P
any rate increase determined by a state reinsurance, risk adjustment, and risk
or CMS to be unreasonable, and a corridors. An issuer must provide an
notification requirement for annual rebate if the amount it spends on DEPARTMENT OF HEALTH AND
unreasonable rate increases which the certain costs compared to its premium HUMAN SERVICES
issuer will not implement. revenue (excluding Federal and States
In order to obtain the information taxes and licensing and regulatory fees) Administration for Children and
necessary to monitor premium increases does not meet a certain ratio, referred to Families
of health insurance coverage offered as the medical loss ratio (MLR). Each
through an Exchange and outside of an issuer is required to submit annually Submission for OMB Review;
asabaliauskas on DSK5VPTVN1PROD with NOTICES
Exchange, 45 CFR 154.215 would MLR data, including information about Comment Request
require health insurance issuers to any rebates it must provide, on a form Title: Native Employment Works
submit the Unified Rate Review prescribed by CMS, for each State in (NEW) Program Plan Guidance and
Template for all single risk pool which the issuer conducts business. Native Employment Works (NEW)
coverage products in the individual or Each issuer is also required to provide Program Report.
small group (or merged) market, a rebate notice to each policyholder that OMB No.: 0970–0174.
regardless of whether any plan within a is owed a rebate and each subscriber of Description: The Native Employment
product is subject to a rate increase. policyholders that are owed a rebate for Works (NEW) program plan is the
VerDate Sep<11>2014 17:59 Feb 18, 2016 Jkt 238001 PO 00000 Frm 00027 Fmt 4703 Sfmt 4703 E:\FR\FM\19FEN1.SGM 19FEN1](https://thefederalregister.org/doc/81_FR_8531/page/3.svg)
Document Created: 2018-02-02 14:31:50
Document Modified: 2018-02-02 14:31:50
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Dates | Comments must be received by April 19, 2016. | |
| Contact | Reports Clearance Office at (410) 786- 1326. | |
| FR Citation | 81 FR 8498 |
2025 Federal Register | Disclaimer | Privacy Policy
USC | CFR | eCFR