83 FR 22267 - Agency Information Collection Activities: Submission for OMB Review; Comment Request
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 83, Issue 93 (May 14, 2018)
Centers for Medicare & Medicaid Services
Federal Register Volume 83, Issue 93 (May 14, 2018)
| Page Range | 22267-22268 | |
| FR Document | 2018-10130 |
[Federal Register Volume 83, Number 93 (Monday, May 14, 2018)] [Notices] [Pages 22267-22268] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2018-10130] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifier: CMS-10307] 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 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 on the collection(s) of information must be received by the OMB desk officer by June 22, 2018. 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' website 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: [[Page 22268]] 1. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: Medical Necessity and Claims Denial Disclosures under MHPAEA; Use: The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) (Pub. L. 110-343) generally requires that group health plans and group health insurance issuers offering mental health or substance use disorder (MH/SUD) benefits in addition to medical and surgical (med/surg) benefits ensure that they do not apply any more restrictive financial requirements (e.g., co-pays, deductibles) and/or treatment limitations (e.g., visit limits) to MH/SUD benefits than those requirements and/or limitations applied to substantially all med/surg benefits. The Patient Protection and Affordable Care Act, Public Law 111-148, was enacted on March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, Public Law 111-152, was enacted on March 30, 2010. These statutes are collectively known as the ``Affordable Care Act.'' The Affordable Care Act extended MHPAEA to apply to the individual health insurance market. Additionally, the Department of Health and Human Services (HHS) final regulation regarding essential health benefits (EHB) requires health insurance issuers offering non- grandfathered health insurance coverage in the individual and small group markets, through an Exchange or outside of an Exchange, to comply with the requirements of the MHPAEA regulations in order to satisfy the requirement to cover EHB (45 CFR 147.150 and 156.115). Medical Necessity Disclosure Under MHPAEA MHPAEA section 512(b) specifically amends the Public Health Service (PHS) Act to require plan administrators or health insurance issuers to provide, upon request, the criteria for medical necessity determinations made with respect to MH/SUD benefits to current or potential participants, beneficiaries, or contracting providers. The Interim Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (75 FR 5410, February 2, 2010) and the Final Rules under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 set forth rules for providing criteria for medical necessity determinations. CMS administers MHPAEA with respect to non-Federal governmental plans and health insurance issuers. Claims Denial Disclosure Under MHPAEA MHPAEA section 512(b) specifically amends the PHS Act to require plan administrators or health insurance issuers to provide, upon request, the reason for any denial or reimbursement of payment for MH/ SUD services to the participant or beneficiary involved in the case. The Interim Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (75 FR 5410, February 2, 2010) and the Final Rules under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 implement 45 CFR 146.136(d)(2), which sets forth rules for providing reasons for claims denial. CMS administers MHPAEA with respect to non- Federal governmental plans and health insurance issuers, and the regulation provides a safe harbor such that non-Federal governmental plans (and issuers offering coverage in connection with such plans) are deemed to comply with requirements of paragraph (d)(2) of 45 CFR 146.136 if they provide the reason for claims denial in a form and manner consistent with ERISA requirements found in 29 CFR 2560.503-1. Section 146.136(d)(3) of the final rule clarifies that PHS Act section 2719 governing internal claims and appeals and external review as implemented by 45 CFR 147.136, covers MHPAEA claims denials and requires that, when a non-quantitative treatment limitation (NQTL) is the basis for a claims denial, that a non-grandfathered plan or issuer must provide the processes, strategies, evidentiary standard, and other factors used in developing and applying the NQTL with respect to med/ surg benefits and MH/SUD benefits. Disclosure Request Form Group health plan participants, beneficiaries, covered individuals in the individual market, or persons acting on their behalf, may use this optional model form to request information from plans regarding NQTLs that may affect patients' MH/SUD benefits or that may have resulted in their coverage being denied. Form Number: CMS-10307 (OMB control number: 0938-1080); Frequency: On Occasion; Affected Public: State, Local, or Tribal Governments, Private Sector, Individuals; Number of Respondents: 267,538; Total Annual Responses: 1,081,929; Total Annual Hours: 43,327. (For policy questions regarding this collection contact Usree Bandyopadhyay at 410-786-6650.) Dated: May 8, 2018. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2018-10130 Filed 5-11-18; 8:45 am] BILLING CODE 4120-01-P
![Federal Register / Vol. 83, No. 93 / Monday, May 14, 2018 / Notices 22267
information to be collected, and the use approved collection; Title of collection for the proper performance of
of automated collection techniques or Information Collection: Survey Report the agency’s functions, the accuracy of
other forms of information technology to Form for Clinical Laboratory the estimated burden, ways to enhance
minimize the information collection Improvement Amendments (CLIA) and the quality, utility, and clarity of the
burden. Supporting Regulations; Use: The form information to be collected and the use
is used to report surveyor findings of automated collection techniques or
DATES: Comments on the collection(s) of
during a CLIA survey. For each type of other forms of information technology to
information must be received by the
survey conducted (i.e., initial minimize the information collection
OMB desk officer by June 13, 2018.
certification, recertification, validation, burden.
ADDRESSES: When commenting on the complaint, addition/deletion of
proposed information collections, DATES: Comments on the collection(s) of
specialty/subspecialty, transfusion
please reference the document identifier information must be received by the
fatality investigation, or revisit
or OMB control number. To be assured OMB desk officer by June 22, 2018.
inspections) the Survey Report Form
consideration, comments and incorporates the requirements specified ADDRESSES: When commenting on the
recommendations must be received by in the CLIA regulations. Form Number: proposed information collections,
the OMB desk officer via one of the CMS–1557 (OMB control number: please reference the document identifier
following transmissions: OMB, Office of 0938–0544); Frequency: Biennially; or OMB control number. To be assured
Information and Regulatory Affairs; Affected Public: Private sector (Business consideration, comments and
Attention: CMS Desk Officer; Fax or other for-profit and Not-for-profit recommendations must be received by
Number: (202) 395–5806 OR Email: institutions, State, Local or Tribal the OMB desk officer via one of the
OIRA_submission@omb.eop.gov. Governments and Federal Government); following transmissions: OMB, Office of
To obtain copies of a supporting Number of Respondents: 19,183; Total Information and Regulatory Affairs,
statement and any related forms for the Annual Responses: 9,592; Total Annual Attention: CMS Desk Officer, Fax
proposed collection(s) summarized in Hours: 4,796. (For policy questions Number: (202) 395–5806 OR Email:
this notice, you may make your request regarding this collection contact OIRA_submission@omb.eop.gov.
using one of following: Kathleen Todd at 410–786–3385). To obtain copies of a supporting
1. Access CMS’ website address at Dated: May 8, 2018.
statement and any related forms for the
website address at https://www.cms.gov/ proposed collection(s) summarized in
William N. Parham, III,
Regulations-and-Guidance/Legislation/ this notice, you may make your request
Director, Paperwork Reduction Staff, Office
PaperworkReductionActof1995/PRA- using one of following:
of Strategic Operations and Regulatory
Listing.html. Affairs. 1. Access CMS’ website address at
1. Email your request, including your http://www.cms.hhs.gov/
[FR Doc. 2018–10135 Filed 5–11–18; 8:45 am]
address, phone number, OMB number, PaperworkReductionActof1995.
BILLING CODE 4120–01–P
and CMS document identifier, to 2. Email your request, including your
Paperwork@cms.hhs.gov. address, phone number, OMB number,
2. Call the Reports Clearance Office at DEPARTMENT OF HEALTH AND and CMS document identifier, to
(410) 786–1326. HUMAN SERVICES Paperwork@cms.hhs.gov.
FOR FURTHER INFORMATION CONTACT: 3. Call the Reports Clearance Office at
Reports Clearance Office at (410) 786– Centers for Medicare & Medicaid (410) 786–1326.
1326. Services FOR FURTHER INFORMATION CONTACT:
SUPPLEMENTARY INFORMATION: Under the [Document Identifier: CMS–10307] Reports Clearance Office at (410) 786–
Paperwork Reduction Act of 1995 (PRA) 1326.
(44 U.S.C. 3501–3520), federal agencies Agency Information Collection SUPPLEMENTARY INFORMATION: Under the
must obtain approval from the Office of Activities: Submission for OMB Paperwork Reduction Act of 1995 (PRA)
Management and Budget (OMB) for each Review; Comment Request (44 U.S.C. 3501–3520), federal agencies
collection of information they conduct AGENCY: Centers for Medicare & must obtain approval from the Office of
or sponsor. The term ‘‘collection of Medicaid Services, HHS. Management and Budget (OMB) for each
information’’ is defined in 44 U.S.C. ACTION: Notice. collection of information they conduct
3502(3) and 5 CFR 1320.3(c) and or sponsor. The term ‘‘collection of
includes agency requests or SUMMARY: The Centers for Medicare & information’’ is defined in 44 U.S.C.
requirements that members of the public Medicaid Services (CMS) is announcing 3502(3) and 5 CFR 1320.3(c) and
submit reports, keep records, or provide an opportunity for the public to includes agency requests or
information to a third party. Section comment on CMS’ intention to collect requirements that members of the public
3506(c)(2)(A) of the PRA (44 U.S.C. information from the public. Under the submit reports, keep records, or provide
3506(c)(2)(A)) requires federal agencies Paperwork Reduction Act of 1995 information to a third party. Section
to publish a 30-day notice in the (PRA), federal agencies are required to 3506(c)(2)(A) of the PRA (44 U.S.C.
Federal Register concerning each publish notice in the Federal Register 3506(c)(2)(A)) requires federal agencies
proposed collection of information, concerning each proposed collection of to publish a 30-day notice in the
including each proposed extension or information, including each proposed Federal Register concerning each
reinstatement of an existing collection extension or reinstatement of an existing proposed collection of information,
of information, before submitting the collection of information, and to allow including each proposed extension or
amozie on DSK3GDR082PROD with NOTICES
collection to OMB for approval. To a second opportunity for public reinstatement of an existing collection
comply with this requirement, CMS is comment on the notice. Interested of information, before submitting the
publishing this notice that summarizes persons are invited to send comments collection to OMB for approval. To
the following proposed collection(s) of regarding the burden estimate or any comply with this requirement, CMS is
information for public comment: other aspect of this collection of publishing this notice that summarizes
1. Type of Information Collection information, including the necessity and the following proposed collection(s) of
Request: Revision of a currently utility of the proposed information information for public comment:
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![22268 Federal Register / Vol. 83, No. 93 / Monday, May 14, 2018 / Notices
1. Type of Information Collection Claims Denial Disclosure Under Dated: May 8, 2018.
Request: Revision of a currently MHPAEA William N. Parham, III,
approved collection; Title of Director, Paperwork Reduction Staff, Office
Information Collection: Medical MHPAEA section 512(b) specifically of Strategic Operations and Regulatory
Necessity and Claims Denial Disclosures amends the PHS Act to require plan Affairs.
under MHPAEA; Use: The Paul administrators or health insurance [FR Doc. 2018–10130 Filed 5–11–18; 8:45 am]
Wellstone and Pete Domenici Mental issuers to provide, upon request, the BILLING CODE 4120–01–P
Health Parity and Addiction Equity Act reason for any denial or reimbursement
of 2008 (MHPAEA) (Pub. L. 110–343) of payment for MH/SUD services to the
generally requires that group health participant or beneficiary involved in DEPARTMENT OF HEALTH AND
plans and group health insurance the case. The Interim Final Rules Under HUMAN SERVICES
issuers offering mental health or the Paul Wellstone and Pete Domenici
substance use disorder (MH/SUD) Mental Health Parity and Addiction Administration for Children and
benefits in addition to medical and Equity Act of 2008 (75 FR 5410, Families
surgical (med/surg) benefits ensure that February 2, 2010) and the Final Rules
Submission for OMB Review;
they do not apply any more restrictive under the Paul Wellstone and Pete
Comment Request
financial requirements (e.g., co-pays, Domenici Mental Health Parity and
deductibles) and/or treatment Addiction Equity Act of 2008 Title: Implementation Grants to
limitations (e.g., visit limits) to MH/SUD implement 45 CFR 146.136(d)(2), which Develop a Model Intervention for
benefits than those requirements and/or sets forth rules for providing reasons for Youth/Young Adults with Child Welfare
limitations applied to substantially all claims denial. CMS administers Involvement at Risk of Homelessness:
med/surg benefits. MHPAEA with respect to non-Federal Phase II—Extension.
The Patient Protection and Affordable governmental plans and health OMB NO.: 0970–0445.
Care Act, Public Law 111–148, was insurance issuers, and the regulation Description: The Administration for
enacted on March 23, 2010, and the provides a safe harbor such that non- Children and Families (ACF) at the U.S.
Health Care and Education Federal governmental plans (and issuers Department of Health and Human
Reconciliation Act of 2010, Public Law offering coverage in connection with Services (HHS) intends to collect data
111–152, was enacted on March 30, such plans) are deemed to comply with for an evaluation of the initiative,
2010. These statutes are collectively requirements of paragraph (d)(2) of 45 Implementation Grants to Develop a
known as the ‘‘Affordable Care Act.’’ CFR 146.136 if they provide the reason Model Intervention for Youth/Young
The Affordable Care Act extended for claims denial in a form and manner Adults with Child Welfare Involvement
MHPAEA to apply to the individual consistent with ERISA requirements at Risk of Homelessness: Phase II. This
health insurance market. Additionally, found in 29 CFR 2560.503–1. Section builds on the previously approved
the Department of Health and Human 146.136(d)(3) of the final rule clarifies ‘‘Planning Grants to Develop a Model
Services (HHS) final regulation that PHS Act section 2719 governing Intervention for Youth/Young Adults
regarding essential health benefits (EHB) internal claims and appeals and external with Child Welfare Involvement at Risk
requires health insurance issuers review as implemented by 45 CFR of Homelessness’’ (Phase I). The Phase
offering non-grandfathered health 147.136, covers MHPAEA claims II data collection described in this
insurance coverage in the individual denials and requires that, when a non- Notice was approved by the Office of
and small group markets, through an quantitative treatment limitation Management and Budget in July 2017.
Exchange or outside of an Exchange, to (NQTL) is the basis for a claims denial, This request is for a time extension for
comply with the requirements of the that a non-grandfathered plan or issuer data collection under OMB# 0970–0445.
MHPAEA regulations in order to satisfy must provide the processes, strategies, There are no changes to the previously
the requirement to cover EHB (45 CFR evidentiary standard, and other factors approved information collection. Due to
147.150 and 156.115). used in developing and applying the delays, data collection has not begun
NQTL with respect to med/surg benefits and will need to extend beyond the
Medical Necessity Disclosure Under
and MH/SUD benefits. current expiration date of July 2018.
MHPAEA
Grantees are receiving an additional
MHPAEA section 512(b) specifically Disclosure Request Form year to conduct their work. To capture
amends the Public Health Service (PHS) data at a similar point in the
Act to require plan administrators or Group health plan participants, development of their efforts, data
health insurance issuers to provide, beneficiaries, covered individuals in the collection will be delayed.
upon request, the criteria for medical individual market, or persons acting on Phase II is an initiative, funded by the
necessity determinations made with their behalf, may use this optional Children’s Bureau (CB) within ACF, that
respect to MH/SUD benefits to current model form to request information from will support implementation grants for
or potential participants, beneficiaries, plans regarding NQTLs that may affect interventions designed to intervene with
or contracting providers. The Interim patients’ MH/SUD benefits or that may youth who have experienced time in
Final Rules Under the Paul Wellstone have resulted in their coverage being foster care and are most likely to have
and Pete Domenici Mental Health Parity denied. Form Number: CMS–10307 a challenging transition into adulthood,
and Addiction Equity Act of 2008 (75 (OMB control number: 0938–1080); including homelessness and unstable
FR 5410, February 2, 2010) and the Frequency: On Occasion; Affected housing experiences. CB awarded six
Final Rules under the Paul Wellstone Public: State, Local, or Tribal implementation grants (Phase II) in
amozie on DSK3GDR082PROD with NOTICES
and Pete Domenici Mental Health Parity Governments, Private Sector, September 2015. During the
and Addiction Equity Act of 2008 set Individuals; Number of Respondents: implementation phase, organizations
forth rules for providing criteria for 267,538; Total Annual Responses: will conduct a range of activities to fine-
medical necessity determinations. CMS 1,081,929; Total Annual Hours: 43,327. tune their comprehensive service
administers MHPAEA with respect to (For policy questions regarding this model, determine whether their model
non-Federal governmental plans and collection contact Usree is being implemented as intended, and
health insurance issuers. Bandyopadhyay at 410–786–6650.) develop plans to evaluate the model
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Document Created: 2018-05-12 01:11:13
Document Modified: 2018-05-12 01:11:13
| 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 on the collection(s) of information must be received by the OMB desk officer by June 22, 2018. | |
| Contact | Reports Clearance Office at (410) 786- 1326. | |
| FR Citation | 83 FR 22267 |
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