82 FR 17997 - Agency Information Collection Activities: Proposed Collection; Comment Request
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 82, Issue 71 (April 14, 2017)
Centers for Medicare & Medicaid Services
Federal Register Volume 82, Issue 71 (April 14, 2017)
| Page Range | 17997-17998 | |
| FR Document | 2017-07568 |
[Federal Register Volume 82, Number 71 (Friday, April 14, 2017)] [Notices] [Pages 17997-17998] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-07568] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifiers: CMS-1561/1561A, CMS-370 and CMS-377, CMS-10488, and CMS-10393] 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 required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden. DATES: Comments must be received by June 13, 2017. ADDRESSES: When commenting, please reference the document identifier or OMB control number. To be assured consideration, comments and recommendations must be submitted in any one of the following ways: 1. Electronically. You may send your comments electronically to http://www.regulations.gov. Follow the instructions for ``Comment or Submission'' or ``More Search Options'' to find the information collection document(s) that are accepting comments. 2. By regular mail. You may mail written comments to the following address: CMS, Office of Strategic Operations and Regulatory Affairs, Division of Regulations Development, Attention: Document Identifier/OMB Control Number ___, Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850. To obtain copies of a supporting statement and any related forms for the proposed collection(s) summarized in this notice, you may make your request using one of following: 1. Access CMS' Web site address at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html. 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: William Parham at (410) 786-4669. 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-1561/1561A Health Insurance Benefit Agreement CMS-370 and CMS-377 ASC Forms for Medicare Program Certification CMS-10488 Consumer Experience Survey Data Collection CMS-10393 Beneficiary and Family Centered Data Collection Under the PRA (44 U.S.C. 3501-3520), federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. The term ``collection of information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party. Section 3506(c)(2)(A) of the PRA requires federal agencies to publish a 60-day notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, before submitting the collection to OMB for approval. To comply with this requirement, CMS is publishing this notice. Information Collection 1. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Health Insurance Benefit Agreement; Use: Applicants to the Medicare program are required to agree to provide services in accordance with federal requirements. The CMS-1561/1561A is essential in that is allows us to ensure that applicants are in compliance with the requirements. Applicants will be required to sign the completed form and provide operational information to us to assure that they continue to meet the requirements after approval. Form Number: CMS-1561/1561A (OMB control number: 0938-0832); Frequency: Yearly; Affected Public: Private sector--(Business or other for-profits and Not-for-profit institutions); Number of Respondents: 2,400; Total Annual Responses: 2,400; Total Annual Hours: 400. (For policy questions regarding this collection contact Shonte Carter at 410-786-3532). 2. Type of Information Collection Request: Extension of a currently approved collection; Titles of Information Collection: ASC Forms for Medicare Program Certification; Use: The CMS-370 is used to establish eligibility for payment. This agreement, upon submission by the ambulatory surgical center (ASC) and acceptance for filing by the Secretary of Health & Human Services, shall be binding on both the ASC and the Secretary. The agreement may be terminated by either party in accordance with regulations. In the event of termination, payment will not be available for ASC services furnished on or after the effective date of termination. The Request for Certification or Update of Certification Information in the Medicare Program Form (CMS-377) [[Page 17998]] is used by State agencies who conduct certification surveys on CMS' behalf to maintain information on the facility's characteristics that facilitate conducting surveys, e.g., determining the size and the composition of the survey team on the basis of the number of ORs/ procedure rooms and the types of surgical procedures performed in the ASC. Form Numbers: CMS-370 and CMS-377 (OMB control number: 0938-0266); Frequency: Occasionally; Affected Public: Private Sector--Business or other for-profit and Not-for-profit institutions; Number of Respondents: 5,694; Total Annual Responses: 1,898; Total Annual Hours: 627. (For policy questions regarding this collection contact Erin McCoy at 410-786-2337.) 3. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: Consumer Experience Survey Data Collection; Use: Section 1311(c)(4) of the Affordable Care Act requires the Department of Health and Human Services (HHS) to develop an enrollee satisfaction survey system that assesses consumer experience with qualified health plans (QHPs) offered through an Exchange. It also requires public display of enrollee satisfaction information by the Exchange to allow individuals to easily compare enrollee satisfaction levels between comparable plans. HHS established the QHP Enrollee Experience Survey (QHP Enrollee Survey) to assess consumer experience with the QHPs offered through the Marketplaces. The survey include topics to assess consumer experience with the health care system such as communication skills of providers and ease of access to health care services. CMS developed the survey using the Consumer Assessment of Health Providers and Systems (CAHPS[supreg]) principles (https://www.ahrq.gov/cahps/about-cahps/principles/index.html) and established an application and approval process for survey vendors who want to participate in collecting QHP enrollee experience data. The QHP Enrollee Survey, which is based on the CAHPS[supreg] Health Plan Survey, will be used to (1) help consumers choose among competing health plans, (2) provide actionable information that the QHPs can use to improve performance, (3) provide information that regulatory and accreditation organizations can use to regulate and accredit plans, and (4) provide a longitudinal database for consumer research. CMS completed two rounds of developmental testing including 2014 psychometric testing and 2015 beta testing of the QHP Enrollee Survey. The psychometric testing helped determine psychometric properties and provided an initial measure of performance for Marketplaces and QHPs to use for quality improvement. Based on psychometric test results, CMS further refined the questionnaire and sampling design to conduct the 2015 beta test of the QHP Enrollee Survey. CMS previously obtained clearance for the 2016 and 2017 administrations of the QHP Enrollee Survey. At this time, CMS is requesting to renew approval for the information collection related to the QHP Enrollee Experience Survey in 2018-2020. These activities are necessary to ensure that CMS fulfills legislative mandates established by section 1311(c)(4) of the Affordable Care Act to develop an ``enrollee satisfaction survey system'' and provide such information on Marketplace Web sites. CMS is also seeking approval to remove eight survey questions beginning with the 2018 survey administration. With the removal of these eight questions, the revised total estimated annual burden hours of national implementation of the QHP Enrollee Survey is 22,523 hours with 90,015 responses. The revised total annualized burden over three years for this requested information collection is 67,569 hours and the total average annualized number of responses is 270,045 responses. Form Number: CMS-10488 (OMB Control Number: 0938-1221); Frequency: Annually; Affected Public: Public sector (Individuals and Households), Private sector (Business or other for-profits and Not-for-profit institutions); Number of Respondents: 90,015; Total Annual Responses: 90,015; Total Annual Hours: 22,523; (For policy questions regarding this collection contact Nidhi Singh-Shah at 301-492-5110.) 4. Type of Information Collection Request: Revision of a previously approved collection; Title of Information Collection: Beneficiary and Family Centered Data Collection; Use: The CMS Quality Improvement Organization (QIO) Program includes Beneficiary and Family Centered Care (BFCC) QIOs whose functions, as set forth in Section 1862(g) of the Social Security Act, are to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. To accomplish these goals, the QIOs review health care services funded under Medicare to determine whether those services are reasonable, medically necessary, furnished in the appropriate setting, and meet professionally recognized standards of quality. The QIOs also review health care services where the beneficiary or a representative has complained about the quality of those services or is appealing alleged premature discharge. Under the current 11th QIO Statement of Work (SOW), two organizations are providing services as BFCC QIOs across all of the United States. The QIO evaluation criteria have been revised to reflect this national regionalization and it is important for CMS to understand the impact on beneficiaries from this reorganization. The information will be used to evaluate the success of each QIO in meeting its contractual requirements and to understand the experience of Medicare beneficiaries and/or their representative with QIO contract mandated work. Form Number: CMS-10393 (OMB Control number: 0938-1177); Frequency: Once; Affected Public: Individuals or households; Number of Respondents: 24,970; Number of Responses: 24,970; Total Annual Hours: 2,899. (For policy questions regarding this collection, contact David Russo at 617-565-1310.) Dated: April 11, 2017. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2017-07568 Filed 4-13-17; 8:45 am] BILLING CODE 4120-01-P
![Federal Register / Vol. 82, No. 71 / Friday, April 14, 2017 / Notices 17997
before the call. If CDC is unable to post the accuracy of the estimated burden, approval from the Office of Management
the background material on the HICPAC ways to enhance the quality, utility, and and Budget (OMB) for each collection of
site prior to the meeting, the background clarity of the information to be information they conduct or sponsor.
material will be posted on HICPAC’s collected, and the use of automated The term ‘‘collection of information’’ is
Web site after the meeting. Background collection techniques or other forms of defined in 44 U.S.C. 3502(3) and 5 CFR
material is available at http:// information technology to minimize the 1320.3(c) and includes agency requests
www.cdc.gov/hicpac. information collection burden. or requirements that members of the
Agenda items are subject to change as DATES: Comments must be received by public submit reports, keep records, or
priorities dictate. June 13, 2017. provide information to a third party.
Contact Person for More Information: ADDRESSES: When commenting, please Section 3506(c)(2)(A) of the PRA
Erin Stone, M.A., HICPAC, Division of reference the document identifier or requires federal agencies to publish a
Healthcare Quality Promotion, NCEZID, OMB control number. To be assured 60-day notice in the Federal Register
CDC, 1600 Clifton Road NE., Mailstop consideration, comments and concerning each proposed collection of
A–31, Atlanta, Georgia 30333; Email: recommendations must be submitted in information, including each proposed
HICPAC@cdc.gov. any one of the following ways: extension or reinstatement of an existing
The Director, Management Analysis 1. Electronically. You may send your collection of information, before
and Services Office, has been delegated comments electronically to http:// submitting the collection to OMB for
the authority to sign Federal Register www.regulations.gov. Follow the approval. To comply with this
notices pertaining to announcements of instructions for ‘‘Comment or requirement, CMS is publishing this
meetings and other committee Submission’’ or ‘‘More Search Options’’ notice.
management activities, for both the to find the information collection Information Collection
Centers for Disease Control and document(s) that are accepting
Prevention and the Agency for Toxic comments. 1. Type of Information Collection
Substances and Disease Registry. 2. By regular mail. You may mail Request: Extension of a currently
written comments to the following approved collection; Title of
Elaine L. Baker, Information Collection: Health
address: CMS, Office of Strategic
Director, Management Analysis and Services Insurance Benefit Agreement; Use:
Office, Centers for Disease Control and Operations and Regulatory Affairs,
Division of Regulations Development, Applicants to the Medicare program are
Prevention.
Attention: Document Identifier/OMB required to agree to provide services in
[FR Doc. 2017–07594 Filed 4–13–17; 8:45 am] accordance with federal requirements.
Control Number lll, Room C4–26–
BILLING CODE 4163–18–P
05, 7500 Security Boulevard, Baltimore, The CMS–1561/1561A is essential in
Maryland 21244–1850. that is allows us to ensure that
To obtain copies of a supporting applicants are in compliance with the
DEPARTMENT OF HEALTH AND requirements. Applicants will be
HUMAN SERVICES statement and any related forms for the
proposed collection(s) summarized in required to sign the completed form and
Centers for Medicare & Medicaid this notice, you may make your request provide operational information to us to
Services using one of following: assure that they continue to meet the
1. Access CMS’ Web site address at requirements after approval. Form
[Document Identifiers: CMS–1561/1561A, https://www.cms.gov/Regulations-and- Number: CMS–1561/1561A (OMB
CMS–370 and CMS–377, CMS–10488, and Guidance/Legislation/Paperwork control number: 0938–0832); Frequency:
CMS–10393] Yearly; Affected Public: Private sector—
ReductionActof1995/PRA-Listing.html.
2. Email your request, including your (Business or other for-profits and Not-
Agency Information Collection
address, phone number, OMB number, for-profit institutions); Number of
Activities: Proposed Collection;
and CMS document identifier, to Respondents: 2,400; Total Annual
Comment Request
Paperwork@cms.hhs.gov. Responses: 2,400; Total Annual Hours:
AGENCY: Centers for Medicare & 3. Call the Reports Clearance Office at 400. (For policy questions regarding this
Medicaid Services, HHS. (410) 786–1326. collection contact Shonte Carter at 410–
ACTION: Notice. FOR FURTHER INFORMATION CONTACT: 786–3532).
William Parham at (410) 786–4669. 2. Type of Information Collection
SUMMARY: The Centers for Medicare & SUPPLEMENTARY INFORMATION: Request: Extension of a currently
Medicaid Services (CMS) is announcing approved collection; Titles of
an opportunity for the public to Contents Information Collection: ASC Forms for
comment on CMS’ intention to collect This notice sets out a summary of the Medicare Program Certification; Use:
information from the public. Under the use and burden associated with the The CMS–370 is used to establish
Paperwork Reduction Act of 1995 (the following information collections. More eligibility for payment. This agreement,
PRA), federal agencies are required to detailed information can be found in upon submission by the ambulatory
publish notice in the Federal Register each collection’s supporting statement surgical center (ASC) and acceptance for
concerning each proposed collection of and associated materials (see filing by the Secretary of Health &
information (including each proposed ADDRESSES). Human Services, shall be binding on
extension or reinstatement of an existing CMS–1561/1561A Health Insurance both the ASC and the Secretary. The
collection of information) and to allow Benefit Agreement agreement may be terminated by either
60 days for public comment on the
sradovich on DSK3GMQ082PROD with NOTICES
CMS–370 and CMS–377 ASC Forms party in accordance with regulations. In
proposed action. Interested persons are for Medicare Program Certification the event of termination, payment will
invited to send comments regarding our CMS–10488 Consumer Experience not be available for ASC services
burden estimates or any other aspect of Survey Data Collection furnished on or after the effective date
this collection of information, including CMS–10393 Beneficiary and Family of termination.
the necessity and utility of the proposed Centered Data Collection The Request for Certification or
information collection for the proper Under the PRA (44 U.S.C. 3501– Update of Certification Information in
performance of the agency’s functions, 3520), federal agencies must obtain the Medicare Program Form (CMS–377)
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![17998 Federal Register / Vol. 82, No. 71 / Friday, April 14, 2017 / Notices
is used by State agencies who conduct including 2014 psychometric testing meet professionally recognized
certification surveys on CMS’ behalf to and 2015 beta testing of the QHP standards of quality. The QIOs also
maintain information on the facility’s Enrollee Survey. The psychometric review health care services where the
characteristics that facilitate conducting testing helped determine psychometric beneficiary or a representative has
surveys, e.g., determining the size and properties and provided an initial complained about the quality of those
the composition of the survey team on measure of performance for services or is appealing alleged
the basis of the number of ORs/ Marketplaces and QHPs to use for premature discharge.
procedure rooms and the types of quality improvement. Based on Under the current 11th QIO Statement
surgical procedures performed in the psychometric test results, CMS further of Work (SOW), two organizations are
ASC. Form Numbers: CMS–370 and refined the questionnaire and sampling providing services as BFCC QIOs across
CMS–377 (OMB control number: 0938– design to conduct the 2015 beta test of all of the United States. The QIO
0266); Frequency: Occasionally; the QHP Enrollee Survey. CMS evaluation criteria have been revised to
Affected Public: Private Sector— previously obtained clearance for the reflect this national regionalization and
Business or other for-profit and Not-for- 2016 and 2017 administrations of the it is important for CMS to understand
profit institutions; Number of QHP Enrollee Survey. the impact on beneficiaries from this
Respondents: 5,694; Total Annual At this time, CMS is requesting to reorganization. The information will be
Responses: 1,898; Total Annual Hours: renew approval for the information used to evaluate the success of each QIO
627. (For policy questions regarding this collection related to the QHP Enrollee in meeting its contractual requirements
collection contact Erin McCoy at 410– Experience Survey in 2018–2020. These and to understand the experience of
786–2337.) activities are necessary to ensure that Medicare beneficiaries and/or their
3. Type of Information Collection CMS fulfills legislative mandates representative with QIO contract
Request: Revision of a currently established by section 1311(c)(4) of the mandated work. Form Number: CMS–
approved collection; Title of Affordable Care Act to develop an 10393 (OMB Control number: 0938–
Information Collection: Consumer ‘‘enrollee satisfaction survey system’’ 1177); Frequency: Once; Affected
Experience Survey Data Collection; Use: and provide such information on Public: Individuals or households;
Section 1311(c)(4) of the Affordable Marketplace Web sites. CMS is also Number of Respondents: 24,970;
Care Act requires the Department of seeking approval to remove eight survey Number of Responses: 24,970; Total
Health and Human Services (HHS) to questions beginning with the 2018 Annual Hours: 2,899. (For policy
develop an enrollee satisfaction survey survey administration. With the removal questions regarding this collection,
system that assesses consumer of these eight questions, the revised contact David Russo at 617–565–1310.)
experience with qualified health plans total estimated annual burden hours of Dated: April 11, 2017.
(QHPs) offered through an Exchange. It national implementation of the QHP William N. Parham, III,
also requires public display of enrollee Enrollee Survey is 22,523 hours with
Director, Paperwork Reduction Staff, Office
satisfaction information by the 90,015 responses. The revised total of Strategic Operations and Regulatory
Exchange to allow individuals to easily annualized burden over three years for Affairs.
compare enrollee satisfaction levels this requested information collection is
[FR Doc. 2017–07568 Filed 4–13–17; 8:45 am]
between comparable plans. HHS 67,569 hours and the total average
BILLING CODE 4120–01–P
established the QHP Enrollee annualized number of responses is
Experience Survey (QHP Enrollee 270,045 responses. Form Number:
Survey) to assess consumer experience CMS–10488 (OMB Control Number: DEPARTMENT OF HEALTH AND
with the QHPs offered through the 0938–1221); Frequency: Annually; HUMAN SERVICES
Marketplaces. The survey include topics Affected Public: Public sector
to assess consumer experience with the (Individuals and Households), Private Centers for Medicare & Medicaid
health care system such as sector (Business or other for-profits and Services
communication skills of providers and Not-for-profit institutions); Number of
ease of access to health care services. Respondents: 90,015; Total Annual [CMS–5523–N]
CMS developed the survey using the Responses: 90,015; Total Annual Hours:
Medicare Program; Funding in Support
Consumer Assessment of Health 22,523; (For policy questions regarding
of the Pennsylvania Rural Health
Providers and Systems (CAHPS®) this collection contact Nidhi Singh-
Model—Cooperative Agreement
principles (https://www.ahrq.gov/ Shah at 301–492–5110.)
cahps/about-cahps/principles/ 4. Type of Information Collection AGENCY: Centers for Medicare &
index.html) and established an Request: Revision of a previously Medicaid Services (CMS), Department
application and approval process for approved collection; Title of of Health and Human Services (HHS).
survey vendors who want to participate Information Collection: Beneficiary and ACTION: Notice.
in collecting QHP enrollee experience Family Centered Data Collection; Use:
data. The CMS Quality Improvement SUMMARY: This notice announces the
The QHP Enrollee Survey, which is Organization (QIO) Program includes issuance of the January 12, 2017 single-
based on the CAHPS® Health Plan Beneficiary and Family Centered Care source cooperative agreement funding
Survey, will be used to (1) help (BFCC) QIOs whose functions, as set opportunity announcement to begin the
consumers choose among competing forth in Section 1862(g) of the Social Pennsylvania Rural Health Model’s
health plans, (2) provide actionable Security Act, are to improve the implementation activities, titled
‘‘Funding in Support of the
sradovich on DSK3GMQ082PROD with NOTICES
information that the QHPs can use to effectiveness, efficiency, economy, and
improve performance, (3) provide quality of services delivered to Medicare Pennsylvania Rural Health Model
information that regulatory and beneficiaries. To accomplish these Cooperative Agreement’’ (the ‘‘Funding
accreditation organizations can use to goals, the QIOs review health care Opportunity’’). This Funding
regulate and accredit plans, and (4) services funded under Medicare to Opportunity is available solely to the
provide a longitudinal database for determine whether those services are Commonwealth of Pennsylvania acting
consumer research. CMS completed two reasonable, medically necessary, through the Pennsylvania Department of
rounds of developmental testing furnished in the appropriate setting, and Health (the ‘‘Commonwealth’’). This
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Document Created: 2017-04-14 00:56:38
Document Modified: 2017-04-14 00:56:38
| 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 June 13, 2017. | |
| Contact | William Parham at (410) 786-4669. | |
| FR Citation | 82 FR 17997 |
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