Change Requests

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QHP Issuers Data Collection for Notices for Plan or Display Errors Special Enrollment Periods (CMS-10595)

Key Information

Abstract

In the final rule, the Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017 (CMS-9937-F), we finalized 45 CFR 156.1256, which requires QHP issuers, in the case of a material plan or benefit display error included in 45 CFR 155.420(d)(12), to notify their enrollees of the error and the enrollees’ eligibility for a special enrollment period within 30 calendar days after the issuer is informed by an Federally- facilitated Exchange (FFE) that the error is corrected, if directed to do so by the FFE. This requirement provides notification to QHP enrollees of errors that may have impacted their QHP selection and enrollment and any associated monthly or annual costs, as well as the availability of a special enrollment period under §155.420(d)(12) for the enrollee to select a different QHP, if desired.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 111 - 156 1311	View Law

Pub.L. 111 - 148 402	View Law

Pub.L. 111 - 156 1312	View Law

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Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services (CMS-10344)

Key Information

Abstract

This provision is mandated by the Affordable Care Act, section 3309. To implement this provision, CMS needs data from the States, identifying full benefit dual-eligible individuals who are receiving home and community-based services. The States will provide these data as a new data value on their monthly MMA Phase Down report. These data are not available from any other source. CMS will use these new data to set the affected beneficiaries' Medicare Part D copayment to zero.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 111 - 148 3309	View Law

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DC School Choice Incentive Program

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Abstract

The DC Opportunity Scholarship Program (OSP) is currently authorized under the Scholarships for Opportunity and Results Act (SOAR). Under the SOAR Act, the US Department of Education awards a grant to a non-profit to administer scholarships to students who reside in the District of Columbia and come from households whose incomes do not exceed 185% of the poverty line (300% of the poverty line for returning students). The current administrator of the OSP is Serving Our Children (SOC). Under the law, priority is given to siblings of students in the program, and students who are currently attending low-performing schools, as defined by Title I. To assist in the student selection and assignment process, the information collected is used to determine the eligibility of those students who are interested in the available scholarships.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 108 - 199 3	View Law

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[Medicaid] Limitations on Provider Related Donations and Health Care Related Taxes; Medicaid and Supporting Regulations in 42 CFR 433.68 and 433.74 (CMS-R-148)

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Abstract

This information collection is necessary to ensure compliance with Sections 1903 and 1923 of the Social Security Act for the purpose of preventing payment of FFP on amounts prohibited by statute.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 433	View Law

42 USC 433.	View Law

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Strategic Prevention Framework for Prescription Drugs (SPF Rx)

Key Information

Abstract

The SPF-Rx program is designed to address nonmedical use of prescription drugs as well as opioid overdoses by raising awareness about the dangers of sharing medications and by working with pharmaceutical and medical communities. The SPF-Rx program aims to promote collaboration between states/tribes and pharmaceutical and medical communities to understand the risks of overprescribing to youth age 12–17 and adults 18 years of age and older and enhance capacity for and access to Prescription Drug Monitoring Program (PDMP) data for prevention purposes.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 516	View Law

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Medicare Advantage and Prescription Drug Program: Final Marketing Provisions CFR 422.111(a)(3) and 423.128(a)(3) (CMS-10260)

Key Information

Abstract

This final rule implements provisions of the Social Security Act (the Act) establishing and regulating the Medicare Advantage (MA) program. The MA program was enacted in Title II of The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) on December 8, 2003. The MA program replaces the Medicare+Choice (M+C) program established under Part C of the title XVIII of the Act, while retaining most key features of the M+C program. The MA program attempts to broadly reform and expand the availability of private health plan options to Medicare beneficiaries. Medicare Advantage (MA) organizations and Prescription Drug Plan Sponsors use the information to comply with the eligibility requirements and the MA and Part D contract requirements. CMS will use this information to ensure that correct information is disclosed to Medicare beneficiaries, both potential enrollees and enrollees.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 108 - 117 201	View Law

Pub.L. 110 - 275 103	View Law

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Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)

Key Information

Abstract

VA Form 21-2680 is used to determine eligibility for the aid and attendance and/or housebound benefits. The purpose of this examination is to record manifestations and findings pertinent to the question of whether the claimant is housebound (confined to the home or immediate premises) or in need of the regular aid and attendance of another person. The report should be in sufficient detail for the VA decision makers to determine the extent that disease or injury produces physical or mental impairment, that loss of coordination or enfeeblement affects the ability: to dress and undress; to feed themselves; to attend to the wants of nature; or keep themselves ordinarily clean and presentable. Findings should be recorded to show whether the claimant is blind or bedridden. Whether the claimant seeks housebound or aid and attendance benefits, the report should reflect how well they ambulate, where they go, and what they are able to do during a typical day. Without this information, entitlement to these benefits cannot be determined.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

38 USC 1521(e)	View Law

38 USC 1114	View Law

38 USC 1115(1)(e)	View Law

38 USC 1311(d)	View Law

38 USC 1541(d)	View Law

38 USC 1541(e)	View Law

38 USC 1521(d)	View Law

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Creditable Coverage Disclosure to CMS OnLine Form and Instructions (CMS-10198)

Key Information

Abstract

Information collection requirements will ensure that entities that currently provide prescription drug benefits to any Medicare Part D eligible individual disclose to CMS whether the prescription drug benefit that they offer is creditable coverage. The disclosure is required to be provide annually and upon any change that affects whether the coverage is creditable prescription drug coverage. This collection also provides creditable coverage disclosure instructions for entities complying with these infromation collection request.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

1 Stat. 1860

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Provider Network Coverage Data Collection (CMS-10594)

Key Information

Abstract

Proposed §156.230(e)(1) would require that QHP issuers make a good faith effort to provide written notice of discontinuation of a provider 30 days prior to the effective date of the change or otherwise as soon as practicable, to enrollees who are patients seen on a regular basis by the provider or who receive primary care from the provider whose contract is discontinuing. This is a third-party disclosure requirement. CMS is not proposing to collect this notice from QHP issuers in FFMs, therefore we are not specifying ways in which we will use the data. The purpose of this notice is to provide consumers information on when their providers will no longer be available in-network in their QHP. In proposed 156.230(f)(2), we require QHP issuers to provide a notice to enrollees of the possibility of out-of-network charges from an out-of-network provider in an in-network setting at least 10 calendar days prior to the service being provided to avoid counting the out-of-network costs against to the annual limitation on cost sharing.

Federal Register Notices

60-Day FRN	View Notice

Authorizing Statutes

Pub.L. 111 - 156 1311	View Law

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JADE Act Questionnaire

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Abstract

The Immigration and Nationality Act (“INA”), 8 U.S.C. § 1101, sets out application and eligibility requirements for aliens seeking to obtain nonimmigrant and immigrant visas. Grounds for the ineligibility of certain individuals to receive a visa or to be admitted to the United States are detailed in INA section 212(a), 8 U.S.C. § 1182(a) and other statutes.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

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Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-grandfathered Group Health Plans and Issuers and Individual Market Issuers (CMS-10338)

Key Information

Abstract

These interim final regulations set forth rules implementing revisions to the Public Health Service (PHS) Act section 2719 for internal claims and appeals and external review processes to implement Section 110 of the No Surprises Act (NSA), which protects participants, beneficiaries, and enrollees in group health plans and group and individual health insurance coverage from receiving surprise medical bills when they receive emergency services, non-emergency services from non-participating providers at participating facilities, and air ambulance services, under certain circumstances. Specifically Section 110 of the NSA amends section 2719 of the PHS Act to require the external review process to apply to participants, beneficiaries, and enrollees of such plans with respect to any adverse determination by a plan or issuer under section 2799A-1 or 2799A-2 of the PHS Act. These protections also extend to grandfathered plans.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

45 USC 147.136	View Law

Pub.L. 110 - 110 No Surprises Act	View Law

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[NCEZID] National Healthcare Safety Network (NHSN) Respiratory Data

Key Information

Abstract

The goal of this information collection is to 1) capture the daily, aggregate impact of COVID-19 on healthcare facilities, and 2) monitor medical capacity to respond at local, state, and national levels. This information will be used to inform the overall real-time COVID-19 response efforts and possible resource allocation, and enable state and local health departments to gain immediate access to the COVID-19 data for healthcare facilities within their jurisdiction. This Revision is submitted to, make minor changes to wording used on several forms, make adjustments to the burden estimate (increase), and to modify the title of the data collection to: National Healthcare Safety Network (NHSN) Respiratory Data.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 242b, k, m	View Law

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Indian Self-Determination and Education Assistance Act Programs, 25 CFR 900

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Abstract

The Indian Self-Determination and Education Assistance Act (ISDEAA), as authorized by 25 USC 450 et. seq., authorizes and directs the Bureau of Indian Affairs (BIA) to contract or compact with, and fund Indian Tribes and Tribal organizations that choose to take over the operation of programs, services, functions and activities (PSFAs) that would otherwise be operated by the BIA. These PSFAs include programs such as law enforcement, social services, and tribal priority allocation programs. Congressional appropriations are divided among BIA and Tribes and Tribal organizations to pay for both the BIA’s direct operation of programs and for the operation of programs by Tribes and Tribal organizations through Self-Determination contracts and compacts. The regulations implementing ISDEAA are at 25 CFR 900. An Indian Tribe or Tribal organization is required to submit this information each time that it proposes to contract with BIA under the ISDEAA. The information collected is used by the BIA to determine applicant eligibility, evaluate applicant capabilities, protect the service population, safeguard Federal funds and resources, and permit the BIA to administer and evaluate Tribal ISDEAA contract programs.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

25 USC 450 et seq	View Law

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Invoice Submissions by Contractors for NRC Contracts/Orders

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Abstract

In administering its contracts, the NRC Acquisition Management Division provides billing instructions for its contractors to follow in preparing invoices. These instructions stipulate the level of detail in which supporting data must be submitted for NRC review. The review of this information ensures that all payments made by NRC for valid and reasonable costs are in accordance with the contract terms and conditions.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 83 - 703 1-311	View Law

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(CMS-10578) Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers

Key Information

Abstract

In response to past terrorist attacks, natural disasters, and the subsequent national need to refine the nation’s strategy to handle emergency situations, there continues to be a coordinated effort across Federal agencies to establish a foundation for development and expansion of emergency preparedness systems. This information collection captures the burden necessary to support the development and implementation of emergency preparedness requirements that will be consistent and enforceable across 17 affected Medicare and Medicaid providers and suppliers. We obtained the data used in this discussion on the number of the various Medicare and Medicaid providers and suppliers from Medicare’s Certification and Survey Provider Enhanced Reporting (CASPER) as of , 2015.June 1, 2016. We have not included data for health care facilities that are not Medicare and/or Medicaid certified. This information collection consists primarily of the review, revision, and/or development of emergency plans, policies and procedures, and training and testing materials to ensure on-going compliance with the requirements contained in the regulation, discussed above.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1396r	View Law

42 USC 1395i	View Law

42 USC 1395x	View Law

42 USC 1396d	View Law

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Restraint and Seclusion Standards for Psychiatric Residential Treatment Facilities (CMS-R-306)

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Abstract

Psychiatric residential treatment facilities are required to report deaths, serious injuries and attempted suicides to State Medicaid Agency and Protection and Advocacy Organization. Also required to provide residents restraint and seclusion policy in writing, and to document resident record of all activities involving use of restraint and seclusion.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 483.350	View Law

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State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations

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Abstract

The Medicaid Eligibility Quality Control (MEQC) program provides states and the District of Columbia (hereinafter, “states”) a unique opportunity to improve the quality and accuracy of their Medicaid and Children’s Health Insurance Program (CHIP) eligibility determinations. The MEQC program is intended to complement the Payment Error Rate Measurement (PERM) program by ensuring state operations make accurate and timely eligibility determinations so that Medicaid and CHIP services are appropriately provided to eligible individuals.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1396b	View Law

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Coverage of Certain Preventive Services Under the Affordable Care Act (CMS-10653)

Key Information

Abstract

Each organization seeking to be treated as an eligible organization that wishes to use the optional accommodation process offered under these final rules must either use the EBSA Form 700 method of self-certification or provide notice to HHS of its religious objection to coverage of all or a subset of contraceptive services.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 111 - 148 1001	View Law

Pub.L. 111 - 148 1563	View Law

42 USC 300gg-13	View Law

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NESHAP for Taconite Iron Ore Processing (40 CFR part 63 subpart RRRRR) (Proposed Rule)

Key Information

Abstract

he National Emission Standards for Hazardous Air Pollutants (NESHAP) for Taconite Iron Ore Processing was proposed on December 18, 2002 and promulgated on October 30, 2003. The NESHAP is codified at 40 CFR Part 63, Subpart RRRRR. The regulations apply to existing facilities and new facilities that either emit or has the potential to emit any single hazardous air pollutant (HAP) at a rate of 9.07 megagrams (10 tons) or more per year or any combination of HAP at a rate of 22.68 megagrams (25 tons) or more per year from all emission sources at the plant site. Affected sources include each new or existing ore crushing and handling operation, ore dryer, indurating furnace, and finished pellet handling operation. The pollutants regulated include HAP metals, using particulate matter (PM) as a surrogate. New facilities include those that commenced construction or reconstruction after the date of the original proposal (December 18, 2002). The NESHAP was last amended in 2020 as part of the residual risk and technology review of the regulation (85 FR 45476, July 28, 2020). The Environmental Protection Agency (EPA) is proposing to add emission standards for mercury, hydrogen chloride and hydrogen fluoride for taconite iron ore indurating furnaces and to require additional notifications and reports to help ensure compliance with the proposed standards. This ICR package summaries the estimated burden and costs for the proposed amendments In general, all NESHAP require initial notifications, performance tests, and periodic reports by the owners/operators of the affected facilities. Owners/operators are also required to maintain records of the occurrence and duration of any failures to meet applicable standards, or any period during which the monitoring system is inoperative. In addition to the notifications, a semiannual report is also required. These notifications, reports, and records are essential in determining compliance, and are required of all sources subject to NESHAP. Any owner or operator subject to the provisions of this part shall maintain a file of these measurements and retain the file for at least 5 years following the date of such measurements, maintenance reports, and records. All reports are sent to the delegated state or local authority. In the event there is no such delegated authority, the reports are sent directly to the United States EPA regional office.

Federal Register Notices

60-Day FRN	View Notice

Authorizing Statutes

42 USC 7401 et.seq.	View Law

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Information Collection Requirements for Non-Exchange Entities (CMS-10666)

Key Information

Abstract

This Information Collection Request (ICR) serves as the formal request for a new data collection clearance associated with the HHS Notice of Benefit and Payment Parameters for 2023 Proposed Rule (2023 Proposed Payment Notice) regarding the authority to allow HHS to collect the necessary information to enable web-brokers and issuers using the Classic DE and EDE pathways to submit a request to deviate from the manner in which standardized options are differentially displayed on HealthCare.gov, if they so choose.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 111 - 148 1400(b)	View Law

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Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10142)

Key Information

Abstract

Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), and implementing regulations at 42 CFR, Medicare Advantage organizations (MAO) and Prescription Drug Plans (PDP) are required to submit an actuarial pricing "bid" for each plan offered to Medicare beneficiaries for approval by the Centers for Medicare & Medicaid Services (CMS). MAOs and PDPs use the Bid Pricing Tool (BPT) software to develop their actuarial pricing bid. The information provided in the BPT is the basis for the plan's enrollee premiums and CMS payments for each contract year.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1395w-24	View Law

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Interstate Arrangement for Combining Employment and Wages

Key Information

Abstract

This report provides data necessary to measure the scope and effect of the program for combining employment and wages covered under different States' laws of a single State and to monitor States' payment and wage transfer performance. States are required to provide this information under Section 3304(a)(9)(B), of the Internal Revenue Code of 1986.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

26 USC 3304(a)(9)(B)	View Law

29 USC 303(a)(6)	View Law

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Income and Eligibility Verification System Confidentiality

Key Information

Abstract

The Income and Eligibility Verification System (IEVS) is required by Title III of the Social Security Act, the Federal Unemployment Tax Act, and related statutes. It addresses the confidentiality and disclosure of state unemployment compensation information as well as the state income and eligibility verification provisions of the Deficit Reduction Act.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

29 USC 49b	View Law

42 USC 503	View Law

26 USC 3304(a)(16)	View Law

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Worker Profiling and Reemployment Services Activity and Worker Profiling and Reemployment Services Outcomes

Key Information

Abstract

The Secretary has interpreted applicable sections of Federal law to require States to identify claimants who are most likely to exhaust their Unemployment Insurance benefits and to provide reemployment services to expedite their return to suitable work. The ETA 9048 report provides information on the basic quarterly activities of the WPRS program, reemployment activities for UI claimants who are likely to exhaust their benefits. The report tracks WPRS claimants from the time they are profiled through the delivery of services. The ETA 9049 report provides information about reemployment outcomes for participants in the WPRS program.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 503(a) and (j)	View Law

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Trends in International Mathematics and Science Study (TIMSS 2027) Main Study International Questionnaire

Key Information

Abstract

The Trends in International Mathematics and Science Study (TIMSS), conducted by the National Center for Education Statistics (NCES), within the U.S. Department of Education (ED), is an international assessment of fourth and eighth grade students’ achievement in mathematics and science. Since its inception in 1995, TIMSS has continued to assess students every 4 years (1995, 1999, 2003, 2007, 2011, 2015, and 2019), with the next TIMSS assessment, TIMSS 2023, being the eighth iteration of the study. In TIMSS 2023, approximately 65 countries or education systems will participate. The United States will participate in TIMSS 2023 to continue to monitor the progress of its students compared to that of other nations and to provide data on factors that may influence student achievement. TIMSS is led by the International Association for the Evaluation of Educational Achievement (IEA), an international collective of research organizations and government agencies that create the frameworks used to develop the assessment, the survey instruments, and the study timeline. IEA decides and agrees upon a common set of standards, procedures, and timelines for collecting and reporting data, all of which must be followed by all participating countries. As a result, TIMSS is able to provide a reliable and comparable measure of student skills in participating countries. In the U.S., NCES conducts this study in collaboration with the IEA and a number of contractors to ensure proper implementation of the study and adoption of practices in adherence to the IEA’s standards. Participation in TIMSS is consistent with NCES’s mandate of acquiring and disseminating data on educational activities and student achievement in the United States compared with foreign nations [The Educational Sciences Reform Act of 2002 (ESRA 2002, 20 U.S.C. §9543)]. Previous requests associated with the TIMSS 2023 field test, which was conducted in March and April 2022, were approved by OMB between May 2021 and February 2022 (OMB# 1850-0695 v.16-19). Because TIMSS is a collaborative effort among many parties, the United States must adhere to the international schedule set forth by the IEA, including the availability of final field test and main study plans as well as draft and final questionnaires. In order to meet the international data collection schedule, to align with recruitment for other NCES studies (e.g., the National Assessment of Education Progress, NAEP), and for schools to put the TIMSS 2023 field test assessment on their Spring 2022 calendars, recruitment activities for the field test began in June of 2021. Recruitment activities for the main study began in January 2022, with the data collection activities currently scheduled to begin in March 2023. This package solicits 30 days of public comment and requests OMB approval for the final international version of the main study questionnaires. Adaptation activities to fit the questionnaire text into the U.S. education context are currently underway. The U.S. questionnaires for the main study will be submitted via non-substantive change request in January 2023.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

20 USC 9573	View Law

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