82 FR 26885 - Reducing Regulatory Burdens Imposed by the Patient Protection and Affordable Care Act & Improving Healthcare Choices To Empower Patients
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Office of the Secretary Federal Register Volume 82, Issue 111 (June 12, 2017)
Centers for Medicare & Medicaid Services
Office of the Secretary
Federal Register Volume 82, Issue 111 (June 12, 2017)
| Page Range | 26885-26887 | |
| FR Document | 2017-12130 |
[Federal Register Volume 82, Number 111 (Monday, June 12, 2017)] [Proposed Rules] [Pages 26885-26887] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-12130] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Chapter IV Office of the Secretary 45 CFR Subtitle A [CMS-9928-NC] RIN 0938-ZB39 Reducing Regulatory Burdens Imposed by the Patient Protection and Affordable Care Act & Improving Healthcare Choices To Empower Patients AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Request for information. ----------------------------------------------------------------------- SUMMARY: The Department of Health and Human Services (HHS) is actively working to reduce regulatory burdens and improve health insurance options under Title I of the Patient Protection and Affordable Care Act. Executive Order 13765, ``Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal,'' directs the Secretary of Health and Human Services to achieve these aims. HHS seeks comment from interested parties to inform its ongoing efforts to create a more patient-centered health care system that adheres to the key principles of affordability, accessibility, quality, innovation, and empowerment. DATES: Comments must be submitted on or before July 12, 2017. ADDRESSES: You may submit comments in one of three ways (please choose only one of the ways listed): 1. Electronically. You may submit electronic comments to http://www.regulations.gov. Follow the ``Submit a comment'' instructions. 2. By regular mail. You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-9928-NC, P.O. Box 8016, Baltimore, MD 21244-8016. Please allow sufficient time for mailed comments to be received before the close of the comment period. 3. By express or overnight mail. You may send written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-9928-NC, [[Page 26886]] Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850. FOR FURTHER INFORMATION CONTACT: Vanessa Jones, (202) 690-7000. SUPPLEMENTARY INFORMATION: Submission of Comments: All submissions received must include the Agency name CMS-9928-NC for this notice. All comments received may be posted without change to http://www.regulations.gov, including any personal information provided. I. Background On January 20, 2017, President Trump issued Executive Order 13765, ``Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal,'' to minimize the unwarranted economic and regulatory burdens of the Patient Protection and Affordable Care Act (PPACA) (Pub. L. 111-148). To meet these objectives, the President directed the Secretary of Health and Human Services (the Secretary) and the heads of all other executive departments and agencies with authorities and responsibilities under the PPACA, to the maximum extent permitted by law, to afford the States more flexibility and control to create a more free and open health care market; provide relief from any provision or requirement of the PPACA that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, health care providers, health insurers, patients, recipients of health care services, purchasers of health insurance, or makers of medical devices, products, or medications; provide greater flexibility to States and cooperate with them in implementing health care programs; and encourage the development of a free and open market in interstate commerce for the offering of health care services and health insurance, with the goal of achieving and preserving maximum options for patients and consumers. The Department of Health and Human Services (HHS) is the federal government's principal agency charged with protecting the health of all Americans and providing essential human services. HHS's responsibilities include Medicare, Medicaid, increasing access to care and private health coverage, support for public health preparedness and emergency response, biomedical research, substance abuse and mental health treatment and prevention, assurance of safe and effective drugs and other medical products, protection of our Nation's food supply, assistance to low income families, the Head Start program, services to older Americans, and direct health services delivery. HHS is comprised of staff divisions and operating divisions, many of which are responsible for promulgating regulations pursuant to HHS's statutory authority. Among HHS's goals is to establish a robust and resilient framework for each HHS division to undertake a periodic, thoughtful analysis of its significant existing regulations issued under Title I of the PPACA, to determine whether each rule advances or impedes HHS priorities of stabilizing the individual and small group health insurance markets; empowering patients and promoting consumer choice; enhancing affordability; and returning regulatory authority to the States. We seek public input on changes that could be made, consistent with current law, to existing regulations under HHS's jurisdiction that would result in a more streamlined, flexible, and less burdensome regulatory structure, including identifying regulations that eliminate jobs or inhibit job creation; are outdated, unnecessary, or ineffective; impose costs that exceed benefits; or create a serious inconsistency or otherwise interfere with regulatory reform initiatives and policies. Since the first weeks of the Administration, HHS has worked to reduce burdens and improve health insurance options under the provisions of Title I of the PPACA for which HHS has jurisdiction. On February 17, 2017, HHS published a proposed rule in the Federal Register entitled, ``Patient Protection and Affordable Care Act; Market Stabilization,'' (82 FR 10980) containing regulatory changes that are critical to stabilizing the individual and small group health insurance markets. After receiving and considering public comment, HHS published the Patient Protection and Affordable Care Act; Market Stabilization Final rule on April 18, 2017 (82 FR 18346). The new rules will place downward pressure on premiums, curb abuses, and encourage full-year enrollment by expanding pre-enrollment verification of eligibility for new exchange enrollees using special enrollment periods; encourage patients to avoid coverage lapses; provide greater flexibility to issuers related to actuarial value of plans; return to the States the authority and means to assess issuer network adequacy; revise the timeline for qualified health plan (QHP) certification and rate review to give issuers flexibility to incorporate benefit changes and maximize the number of coverage options available to patients; and more closely align the open enrollment period for the individual market with the employer-sponsored insurance market and Medicare, thus helping to lower prices for Americans by reducing adverse selection. We have also taken a number of other steps to reduce burden, improve choices, and stabilize the insurance market:Issued guidance announcing HHS's intent to propose new health coverage enrollment options for small businesses enrolling through the Federally-facilitated Small Business Health Options Program (FF-SHOP), reducing burdens and making it easier for small employers and their employees to purchase coverage. Announced a new streamlined and simplified direct enrollment process for consumers signing up for individual market coverage with the assistance of web-brokers or issuers in states with Exchanges that rely on HealthCare.gov for their eligibility and enrollment functions. Issued guidance to States explaining their freedom to seek innovative approaches to lowering premiums and protecting consumers via State innovation waivers under section 1332 of the PPACA, which included new information to help states seek waivers from requirements in Title I of the PPACA, and establish high-risk pools/state-operated reinsurance programs. Extended the HHS Risk Adjustment and Data Validation (HHS- RADV) pilot by another year, providing needed flexibility for issuers to adapt to the new HHS-RADV audit tool and protocols to ensure that lessons learned from the first pilot year are implemented effectively, and enabling the Centers for Medicaid & Medicare Services (CMS) to ensure that issuers are compliant with all HHS-RADV requirements, increasing the stability of the markets and the integrity of risk adjustment transfers. Adjusted the QHP certification calendar, to provide issuers additional time to prepare and States additional time to review 2018 products and rates with greater certainty in response to recent policy changes. Issued guidance to issuers allowing patients to keep their transitional individual and small group insurance plans in 2018. These initial steps will help issuers and States work with HHS to achieve shared goals, including stabilizing the individual and small group health insurance markets; empowering patients and promoting consumer choice; enhancing affordability; and affirming the traditional authority of the States in regulating the business of health insurance. In this Request for Information, HHS now seeks input from the public on other changes within its [[Page 26887]] authority and consistent with the law to further achieve these aims. II. Solicitation of Comments HHS is interested in soliciting public comments about changes to existing regulations or guidance, or other actions within HHS's authority, that could further the following goals with respect to the individual and small group health insurance markets: 1. Empowering patients and promoting consumer choice. What activities would best inform consumers and help them choose a plan that best meets their needs? Which regulations currently reduce consumer choices of how to finance their health care and health insurance needs? Choice includes the freedom to choose how to finance one's healthcare, which insurer to use, and which provider to use. 2. Stabilizing the individual, small group, and non-traditional health insurance markets. What changes would bring stability to the risk pool, promote continuous coverage, increase the number of younger and healthier consumers purchasing plans, reduce uncertainty and volatility, and encourage uninsured individuals to buy coverage? 3. Enhancing affordability. What steps can HHS take to enhance the affordability of coverage for individual consumers and small businesses? 4. Affirming the traditional regulatory authority of the States in regulating the business of health insurance. Which HHS regulations or policies have impeded or unnecessarily interfered with States' primary role in regulating the health insurance markets they know best? This is a request for information only. Respondents are encouraged to provide complete but concise responses to the questions outlined above. We note that a response to every question is not required. This request for information is issued solely for information and planning purposes; it does not constitute a notice of proposed rulemaking or request for proposals, applications, proposal abstracts, or quotations. This request for information does not commit the United States Government (``Government'') to contract for any supplies or services or make a grant award. Further, HHS is not seeking proposals through this request for information and will not accept unsolicited proposals. Respondents are advised that the Government will not pay for any information or administrative costs incurred in response to this request for information; all costs associated with responding to this request for information will be solely at the interested party's expense. Not responding to this request for information does not preclude participation in any future rulemaking or procurement, if conducted. It is the responsibility of the potential responders to monitor this request for information announcement for additional information pertaining to this request. We also note that HHS will not respond to questions about the policy issues raised in this request for information. HHS may or may not choose to contact individual responders. Such communications would only serve to further clarify written responses. Contractor support personnel may be used to review request for information responses. Responses to this notice are not offers and cannot be accepted by the Government to form a binding contract or issue a grant. Information obtained as a result of this request for information may be used by the Government for program planning on a non-attribution basis. Respondents should not include any information that might be considered proprietary or confidential. This request for information should not be construed as a commitment or authorization to incur cost for which reimbursement would be required or sought. All submissions become Government property and will not be returned. HHS may publically post the comments received, or a summary thereof. While responses to this request for information do not bind HHS to any further actions related to the response, all submissions will be made publicly available on http://www.regulations.gov. III. Collection of Information Requirements This document does not impose information collection requirements, that is, reporting, recordkeeping or third-party disclosure requirements. This request for information constitutes a general solicitation of comments. In accordance with the implementing regulations of the Paperwork Reduction Act (PRA) at 5 CFR 1320.3(h)(4), information subject to the PRA does not generally include ``facts or opinions submitted in response to general solicitations of comments from the public, published in the Federal Register or other publications, regardless of the form or format thereof, provided that no person is required to supply specific information pertaining to the commenter, other than that necessary for self-identification, as a condition of the agency's full consideration of the comment.'' Consequently, this document need not be reviewed by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.). Dated: June 6, 2017. Seema Verma, Administrator, Centers for Medicare & Medicaid Services. Dated: June 7, 2017. Thomas E. Price, Secretary, Department of Health and Human Services. [FR Doc. 2017-12130 Filed 6-8-17; 4:15 pm] BILLING CODE 4120-01-P
![Federal Register / Vol. 82, No. 111 / Monday, June 12, 2017 / Proposed Rules 26885
found at http://www2.epa.gov/laws- G. Executive Order 13045: Protection of DEPARTMENT OF HEALTH AND
regulations/laws-and-executive-orders. Children From Environmental Health HUMAN SERVICES
Risks and Safety Risks
A. Executive Order 12866: Regulatory Centers for Medicare & Medicaid
Planning and Review and Executive The EPA interprets Executive Order Services
Order 13563: Improving Regulation and 13045 as applying only to those
Regulatory Review regulatory actions that concern 42 CFR Chapter IV
This action is not a significant environmental health or safety risks that
regulatory action and was therefore not the EPA has reason to believe may Office of the Secretary
submitted to the Office of Management disproportionately affect children, per
the definition of ‘‘covered regulatory 45 CFR Subtitle A
and Budget (OMB) for review.
action’’ in section 2–202 of the
B. Paperwork Reduction Act (PRA) [CMS–9928–NC]
Executive Order. This action is not
subject to Executive Order 13045 RIN 0938–ZB39
This action does not impose an
because it does not impose additional
information collection burden under the Reducing Regulatory Burdens
requirements beyond those imposed by
PRA because this action does not Imposed by the Patient Protection and
impose additional requirements beyond state law.
Affordable Care Act & Improving
those imposed by state law. H. Executive Order 13211: Actions That Healthcare Choices To Empower
C. Regulatory Flexibility Act (RFA) Significantly Affect Energy Supply, Patients
Distribution, or Use
I certify that this action will not have AGENCY: Centers for Medicare &
a significant economic impact on a This action is not subject to Executive Medicaid Services (CMS), HHS.
substantial number of small entities Order 13211, because it is not a ACTION: Request for information.
under the RFA. This action will not significant regulatory action under
impose any requirements on small Executive Order 12866. SUMMARY: The Department of Health and
Human Services (HHS) is actively
entities beyond those imposed by state I. National Technology Transfer and working to reduce regulatory burdens
law. Advancement Act (NTTAA) and improve health insurance options
D. Unfunded Mandates Reform Act under Title I of the Patient Protection
Section 12(d) of the NTTAA directs
(UMRA) and Affordable Care Act. Executive
the EPA to use voluntary consensus Order 13765, ‘‘Minimizing the
This action does not contain any standards in its regulatory activities Economic Burden of the Patient
unfunded mandate as described in unless to do so would be inconsistent Protection and Affordable Care Act
UMRA, 2 U.S.C. 1531–1538, and does with applicable law or otherwise Pending Repeal,’’ directs the Secretary
not significantly or uniquely affect small impractical. The EPA believes that this of Health and Human Services to
governments. This action does not action is not subject to the requirements achieve these aims. HHS seeks comment
impose additional requirements beyond of section 12(d) of the NTTAA because from interested parties to inform its
those imposed by state law. application of those requirements would ongoing efforts to create a more patient-
Accordingly, no additional costs to be inconsistent with the CAA. centered health care system that adheres
State, local, or tribal governments, or to to the key principles of affordability,
the private sector, will result from this J. Executive Order 12898: Federal
accessibility, quality, innovation, and
action. Actions To Address Environmental
empowerment.
Justice in Minority Populations and
E. Executive Order 13132: Federalism Low-Income Population DATES: Comments must be submitted on
or before July 12, 2017.
This action does not have federalism The EPA lacks the discretionary ADDRESSES: You may submit comments
implications. It will not have substantial authority to address environmental in one of three ways (please choose only
direct effects on the states, on the justice in this rulemaking. one of the ways listed):
relationship between the national 1. Electronically. You may submit
government and the states, or on the List of Subjects in 40 CFR Part 52
electronic comments to http://
distribution of power and www.regulations.gov. Follow the
Environmental protection, Air
responsibilities among the various ‘‘Submit a comment’’ instructions.
pollution control, Incorporation by
levels of government. 2. By regular mail. You may mail
reference, Intergovernmental relations,
F. Executive Order 13175: Coordination New Source Review, Ozone, Particulate written comments to the following
With Indian Tribal Governments matter, Reporting and recordkeeping address ONLY: Centers for Medicare &
requirements, Volatile organic Medicaid Services, Department of
This action does not have tribal compounds. Health and Human Services, Attention:
implications, as specified in Executive CMS–9928–NC, P.O. Box 8016,
Order 13175, because the SIP is not Authority: 42 U.S.C. 7401 et seq. Baltimore, MD 21244–8016.
asabaliauskas on DSKBBXCHB2PROD with PROPOSALS
approved to apply on any Indian Dated: May 19, 2017. Please allow sufficient time for mailed
reservation land or in any other area Alexis Strauss, comments to be received before the
where the EPA or an Indian tribe has Acting Regional Administrator, Region IX.
close of the comment period.
demonstrated that a tribe has 3. By express or overnight mail. You
[FR Doc. 2017–12134 Filed 6–9–17; 8:45 am]
jurisdiction, and will not impose may send written comments to the
substantial direct costs on tribal BILLING CODE 6560–50–P following address ONLY: Centers for
governments or preempt tribal law. Medicare & Medicaid Services,
Thus, Executive Order 13175 does not Department of Health and Human
apply to this action. Services, Attention: CMS–9928–NC,
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![Federal Register / Vol. 82, No. 111 / Monday, June 12, 2017 / Proposed Rules 26887
authority and consistent with the law to solely at the interested party’s expense. authority of the Paperwork Reduction
further achieve these aims. Not responding to this request for Act of 1995 (44 U.S.C. 3501 et seq.).
information does not preclude Dated: June 6, 2017.
II. Solicitation of Comments
participation in any future rulemaking Seema Verma,
HHS is interested in soliciting public or procurement, if conducted. It is the
comments about changes to existing Administrator, Centers for Medicare &
responsibility of the potential
regulations or guidance, or other actions Medicaid Services.
responders to monitor this request for
within HHS’s authority, that could information announcement for Dated: June 7, 2017.
further the following goals with respect additional information pertaining to this Thomas E. Price,
to the individual and small group health request. We also note that HHS will not Secretary, Department of Health and Human
insurance markets: respond to questions about the policy Services.
1. Empowering patients and issues raised in this request for [FR Doc. 2017–12130 Filed 6–8–17; 4:15 pm]
promoting consumer choice. What information. HHS may or may not BILLING CODE 4120–01–P
activities would best inform consumers choose to contact individual responders.
and help them choose a plan that best Such communications would only serve
meets their needs? Which regulations to further clarify written responses. FEDERAL COMMUNICATIONS
currently reduce consumer choices of Contractor support personnel may be COMMISSION
how to finance their health care and used to review request for information
health insurance needs? Choice responses. Responses to this notice are 47 CFR Part 73
includes the freedom to choose how to not offers and cannot be accepted by the
finance one’s healthcare, which insurer [MB Docket No. 11–54; RM–11624; DA 17–
Government to form a binding contract
to use, and which provider to use. 510]
or issue a grant. Information obtained as
2. Stabilizing the individual, small a result of this request for information
group, and non-traditional health Television Broadcasting Services;
may be used by the Government for Augusta, Georgia
insurance markets. What changes would program planning on a non-attribution
bring stability to the risk pool, promote basis. Respondents should not include AGENCY: Federal Communications
continuous coverage, increase the any information that might be Commission.
number of younger and healthier considered proprietary or confidential. ACTION: Proposed rule; withdrawal.
consumers purchasing plans, reduce This request for information should not
uncertainty and volatility, and be construed as a commitment or SUMMARY: The Commission has before it
encourage uninsured individuals to buy authorization to incur cost for which a petition for rulemaking filed by
coverage? reimbursement would be required or Southern Media Holdings, Inc. (SMH),
3. Enhancing affordability. What steps sought. All submissions become the former licensee of WFXG, Augusta,
can HHS take to enhance the Government property and will not be Georgia, requesting the substitution of
affordability of coverage for individual returned. HHS may publically post the channel 51 for channel 31 at Augusta.
consumers and small businesses? comments received, or a summary WFXG License Subsidiary, LLC
4. Affirming the traditional regulatory thereof. While responses to this request (Licensee) is now the licensee of WFXG.
authority of the States in regulating the for information do not bind HHS to any Station WFXG was allotted channel 51
business of health insurance. Which further actions related to the response, as its post-transition DTV channel and
HHS regulations or policies have all submissions will be made publicly operated a licensed facility on that
impeded or unnecessarily interfered available on http://www.regulations.gov. channel. In 2008, SMH filed a petition
with States’ primary role in regulating for rulemaking requesting that channel
the health insurance markets they know III. Collection of Information
31 be substituted for channel 51, and
best? Requirements
the Commission granted that request.
This is a request for information only. This document does not impose SMH subsequently requested that the
Respondents are encouraged to provide information collection requirements, Commission change its channel back to
complete but concise responses to the that is, reporting, recordkeeping or channel 51 and we issued a Notice of
questions outlined above. We note that third-party disclosure requirements. Proposed Rulemaking, which was
a response to every question is not This request for information constitutes contested. On April 28, 2017, Licensee
required. This request for information is a general solicitation of comments. In filed a letter withdrawing its pending
issued solely for information and accordance with the implementing request to substitute channel 51 for
planning purposes; it does not regulations of the Paperwork Reduction channel 31, explaining that it had
constitute a notice of proposed Act (PRA) at 5 CFR 1320.3(h)(4), licensed the channel 31 facility and that
rulemaking or request for proposals, information subject to the PRA does not WFXG was reassigned to channel 36 in
applications, proposal abstracts, or generally include ‘‘facts or opinions connection with the post-incentive
quotations. This request for information submitted in response to general auction repacking of the broadcast
does not commit the United States solicitations of comments from the television spectrum.
Government (‘‘Government’’) to contract public, published in the Federal
DATES: The proposed rule published on
for any supplies or services or make a Register or other publications,
grant award. Further, HHS is not regardless of the form or format thereof, April 4, 2011 (76 FR 18497) is
asabaliauskas on DSKBBXCHB2PROD with PROPOSALS
seeking proposals through this request provided that no person is required to withdrawn as of June 12, 2017.
for information and will not accept supply specific information pertaining FOR FURTHER INFORMATION CONTACT:
unsolicited proposals. Respondents are to the commenter, other than that Joyce Bernstein, Joyce.Bernstein@
advised that the Government will not necessary for self-identification, as a fcc.gov, Media Bureau, (202) 418–1647.
pay for any information or condition of the agency’s full SUPPLEMENTARY INFORMATION: This is a
administrative costs incurred in consideration of the comment.’’ synopsis of the Commission’s Order,
response to this request for information; Consequently, this document need not MB Docket No. 11–54, adopted May 25,
all costs associated with responding to be reviewed by the Office of 20017, and released May 25, 2017. The
this request for information will be Management and Budget under the full text of this document is available for
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Document Created: 2017-06-10 01:40:50
Document Modified: 2017-06-10 01:40:50
| 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 | Proposed Rules | |
| Action | Request for information. | |
| Dates | Comments must be submitted on or before July 12, 2017. | |
| Contact | Vanessa Jones, (202) 690-7000. | |
| FR Citation | 82 FR 26885 | |
| RIN Number | 0938-ZB39 |
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