Notice2022-00119
Medicaid and Children's Health Insurance Program (CHIP) Generic Information Collection Activities: Proposed Collection; Comment Request
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
January 7, 2022
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
On May 28, 2010, the Office of Management and Budget (OMB) issued Paperwork Reduction Act (PRA) guidance \1\ related to the "generic" clearance process. Generally, this is an expedited process by which agencies may obtain OMB's approval of collection of information requests that are "usually voluntary, low-burden, and uncontroversial collections," do not raise any substantive or policy issues, and do not require policy or methodological review. The process requires the submission of an overarching plan that defines the scope of the individual collections that would fall under its umbrella. On October 23, 2011, OMB approved our initial request to use the generic clearance process under control number 0938-1148 (CMS-10398). It was last approved on April 26, 2021, via the standard PRA process which included the publication of 60- and 30-day Federal Register notices. The scope of the April 2021 umbrella accounts for Medicaid and CHIP State plan amendments, waivers, demonstrations, and reporting. This Federal Register notice seeks public comment on one or more of our collection of information requests that we believe are generic and fall within the scope of the umbrella. Interested persons are invited to submit 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. ---------------------------------------------------------------------------
Full Text
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<title>Federal Register, Volume 87 Issue 5 (Friday, January 7, 2022)</title>
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[Federal Register Volume 87, Number 5 (Friday, January 7, 2022)]
[Notices]
[Pages 980-982]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-00119]
[[Page 980]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-10398 #13, #24, #73, #74, and #75]
Medicaid and Children's Health Insurance Program (CHIP) Generic
Information Collection Activities: Proposed Collection; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, Health and Human
Services (HHS).
ACTION: Notice.
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SUMMARY: On May 28, 2010, the Office of Management and Budget (OMB)
issued Paperwork Reduction Act (PRA) guidance \1\ related to the
``generic'' clearance process. Generally, this is an expedited process
by which agencies may obtain OMB's approval of collection of
information requests that are ``usually voluntary, low-burden, and
uncontroversial collections,'' do not raise any substantive or policy
issues, and do not require policy or methodological review. The process
requires the submission of an overarching plan that defines the scope
of the individual collections that would fall under its umbrella. On
October 23, 2011, OMB approved our initial request to use the generic
clearance process under control number 0938-1148 (CMS-10398). It was
last approved on April 26, 2021, via the standard PRA process which
included the publication of 60- and 30-day Federal Register notices.
The scope of the April 2021 umbrella accounts for Medicaid and CHIP
State plan amendments, waivers, demonstrations, and reporting. This
Federal Register notice seeks public comment on one or more of our
collection of information requests that we believe are generic and fall
within the scope of the umbrella. Interested persons are invited to
submit 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.
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\1\ <a href="https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/assets/inforeg/PRA_Gen_ICRs_5-28-2010.pdf">https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/assets/inforeg/PRA_Gen_ICRs_5-28-2010.pdf</a>.
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DATES: Comments must be received by January 21, 2022.
ADDRESSES: When commenting, please reference the applicable form number
(see below) and the OMB control number (0938-1148). 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
<a href="http://www.regulations.gov">http://www.regulations.gov</a>. 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: CMS-10398 (#74)/OMB
control number: 0938-1148, 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
access CMS' website at <a href="https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html">https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html</a>.
FOR FURTHER INFORMATION CONTACT: William N. Parham at (410) 786-4669.
SUPPLEMENTARY INFORMATION: Following is a summary of the use and burden
associated with the subject information collection(s). More detailed
information can be found in the collection's supporting statement and
associated materials (see ADDRESSES).
Generic Information Collections
1. Title of Information Collection: Medicaid Accountability--
Nursing Facility, Outpatient Hospital and Inpatient Hospital Upper
Payment Limits; Type of Information Collection Request: Revision of a
currently approved collection; Use: Starting in 2013, CMS required
states to submit annual upper payment limit (UPL) demonstrations on an
annual basis. Previously this information was collected or updated only
when a state was proposing an amendment to a reimbursement methodology
in its Medicaid state plan. Specifically, in 2013, we required that
states submit UPL demonstrations for inpatient hospital services,
outpatient hospital services, and nursing facilities. In 2014, states
were then required to submit annual UPL demonstrations for the services
listed above as well as clinics, physician services (for states that
reimburse targeted physician supplemental payments), Intermediate care
facilities for individuals with intellectual disabilities (ICF/IID),
psychiatric residential treatment facilities (PRTFs) and institutes for
mental disease (IMDs). These annual demonstrations included provider
specific data reporting on all payments made to the providers,
including supplemental payments.
Through this process, States were also asked as part of the
submission to identify the source of the non-federal share of funding.
for the payments described in the UPL. This is consistent with the
overall requirements to identify sources of non-federal funding set
forth in section 1903(d)(1) of the Social Security Act. Such
information will allow CMS and the State to have a better understanding
of the variables surrounding rate levels, supplemental payments, and
total providers participating in the programs and the funding
supporting each of the payments described in the UPL demonstration.
In early 2021 CMS developed and revised the templates in
conjunction with the States and a CMS contractor for use with each of
the 3 services of the UPL demonstration within this package--Nursing
Facility, Outpatient Hospital, and Inpatient Hospital. These templates
are helping to standardize the data collection and allow the States to
quickly transfer data from their existing UPL demonstration reporting
tools into the new UPL demonstration templates for reporting to CMS.
These templates have allowed the States to report the UPL
demonstrations more efficiently with embedded formulas to help complete
required areas of the UPL demonstrations, saving States time and effort
in their reporting. Standardizing the templates has helped CMS to
review the annual UPL demonstrations, by being able to look at one
template format, instead of up to 54 different templates in each UPL
demonstration types.
In this December 2021 revision, CMS is moving its Guidance and
Instruction documents into an online format within the MACFin system.
The Guidance and Instruction documents for each of the service type
have been revised and will be collected online, a change from the
previous collection of information where States responded via a Word
type document and sent those responses to a dedicated UPL email box.
Now States will be able to fill in the Guidance and Instruction
documents as needed online. These two documents are now
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combined in the online format and answered online as shown in the
attached materials. Attached here are a walkthrough of the proposed
changes for each service type and separate files for each of the screen
pictures of the proposed questions and logical flow of the questions,
that will become the online format for each service type. After
answering the new online Guidance and Instructions, State personnel
will then upload their UPL templates directly into the MACFin system
for processing.
CMS has revised the Guidance and Instruction and the UPL templates.
These changes are minor but substantive. The Guidance and Instruction
documents were revised to accommodate an online format and to clarify
the questions and data sources States use in calculating the UPL. Some
additional questions have been asked (3), some eliminated (10), and
others have been clarified, but the overall burden for States of 40
hours for each UPL package remains the same, though CMS anticipates the
changes will save burden to States, as the online system will allow for
a logical flow to the questions and only ask the relevant questions for
each State's UPL submission.
The UPL templates have been revised to clarify definitions and
instructions in filling out the UPL templates. The nursing facility
template adds a tab to give States the option to use the Medicare
created Patient Driven Payment Model (PDPM) as an option for the
nursing facility UPL reporting. The new PDPM tab gives states the
option of this new payment methodology, but does not require new data
to be collected. None of the changes add burden to States, and CMS
anticipates the new MACFin system will make it easier for States to
upload and track their required UPL submissions. Form Number: CMS-10398
(#13) (OMB control number: 0938-1148); Frequency: Yearly; Affected
Public: State, Local, or Tribal Governments; Number of Respondents: 54;
Total Annual Responses: 54; Total Annual Hours: 2,160. (For policy
questions regarding this collection contact: Richard Kimball at 410-
786-2278.)
2. Title of Information Collection: Medicaid Accountability--Upper
Payment Limits for Clinics, Physician Services, ICF/IID, PRTFs, and
IMDs; Type of Information Collection Request: Revision of a currently
approved collection; Use: Starting in 2013, CMS required states to
submit annual upper payment limit (UPL) demonstrations on an annual
basis. Previously this information was collected or updated only when a
state was proposing an amendment to a reimbursement methodology in its
Medicaid state plan. Specifically, in 2013, we required that states
submit UPL demonstrations for inpatient hospital services, outpatient
hospital services, nursing facilities. In 2014, states were required to
submit annual UPL demonstrations for the services listed above and
clinics, physician services (for states that reimburse targeted
physician supplemental payments), intermediate care facilities for
Individuals with Intellectual Disabilities (ICF/IID), psychiatric
residential treatment facilities (PRTFs) and institutes for mental
disease (IMDs). These annual demonstrations included provider specific
data reporting on all payments made to the providers, including
supplemental payments.
Through this process, States are also asked as part of the
submission to identify the source of non-federal funding for the
payments described in the UPL. This is consistent with overall
requirements to identify sources of non-federal funding set forth in
section 1903(d)(1) of the Social Security Act. Such information will
allow CMS and the state to have a better understanding of the variables
surrounding rate levels, supplemental payments and total providers
participating in the programs and the funding supporting each of the
payments described in the UPL demonstration.
In early 2021 CMS developed and revised the templates in
conjunction with the States and a CMS contractor for use with each of
the 5 services of the UPL demonstration within this package--
Intermediate care facilities for individuals with intellectual
disabilities (ICF/IID), Clinic services, Medicaid qualified
practitioner services (Physician), other Psychiatric Residential
Treatment Facilities (PRTFs), and Institutes for mental diseases
(IMDs). These templates are helping to standardize the data collection
and allow the states to quickly transfer data from their existing UPL
demonstration reporting tools into the new UPL demonstration templates
for reporting to CMS. These templates have allowed the states to report
the UPL demonstrations more efficiently with embedded formulas to help
complete required areas of the UPL demonstrations, saving States time
and effort in their reporting. Standardizing the templates has helped
CMS to review the annual UPL demonstrations, by being able to look at
one template format, instead of up to 54 different templates in each
UPL demonstration types. Instructions on the use of the templates are
attached to each template, along with a data dictionary.
In this December 2021 revision, CMS is moving its Guidance and
Instruction documents into an online format within the MACFin system.
The Guidance and Instruction documents for each of the service type
have been revised and will be collected online, a change from the
previous collection of information where States responded via a Word
type document and sent those responses to a dedicated UPL email box.
Now States will be able to fill in the Guidance and Instruction
documents as needed online. These two documents are now combined in the
online format and answered online as shown in the attached materials.
Attached here are a walkthrough of the proposed changes for each
service type and separate files for each of the screen pictures of the
proposed questions and logical flow of the questions, that will become
the online format for each service type. After answering the new online
Guidance and Instructions, State personnel will then upload their UPL
templates directly into the MACFin system for processing.
CMS has revised the Guidance and Instruction and the UPL templates.
The IMD guidance and instructions were previously the same as the
inpatient hospital guidance and instructions. Now the IMD has its own
specific guidance and instructions.
These changes are minor but substantive. The Guidance and
Instruction documents were revised as noted in the changes document to
accommodate an online format and to clarify the questions and data
sources States use in calculating the UPL. Some additional questions
have been asked (50), some eliminated (36), and others have been
clarified, but the overall burden for States of 40 hours for each UPL
package remains the same, though CMS anticipates the changes will save
burden to States, as the online system will allow for a logical flow to
the questions and only ask the relevant questions for each State's UPL
submission.
The UPL templates have been revised to clarify definitions and
instructions in filling out the UPL templates. None of the changes add
burden to States, and CMS anticipates the new MACFin system will make
it easier for States to upload and track their required UPL
submissions.
The standard funding questions have been revised for consistency
with language in reviewing state plan amendments, instead of referring
to the SMDL, we now refer to the state plan pages relevant to the
funding
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questions--attachments 4.19-A, 4.19-B, and 4.-19-D. The questions
concerning the source of funding have not changed, therefore there is
no change in the burden to States. Form Number: CMS-10398 (#24) (OMB
control number: 0938-1148); Frequency: Yearly; Affected Public: State,
Local, or Tribal Governments; Number of Respondents: 54; Total Annual
Responses: 54; Total Annual Hours: 2,160. (For policy questions
regarding this collection contact: Richard Kimball at 410-786-2278.)
3. Title of Information Collection: Supplemental Payment Reporting
under the Consolidated Appropriations Act; Type of Information
Collection Request: Extension of a currently approved collection; Use:
Through passage of Division CC, Title II, Section 202 of the
Consolidated Appropriations Act (CAA), Congress added subsection (bb)
to section 1903 of the Act, which requires the Secretary of Health and
Human Services to establish a system for states to submit reports on
supplemental payments as defined in section 1903(bb)(2) of the Act.
States are required to submit ``reports, as determined appropriate by
the Secretary, on supplemental payment data, as a requirement for a
State plan or State plan amendment [SPA] that would provide for a
supplemental payment'' as required by section 1903(bb)(1) of the Act.
CMS is implementing section 202 of the CAA of 2021 by adding new
screens to the CMS-64 in the MBES system for states to report all
supplemental payments. States will be expected to use the form starting
for their first quarter Federal fiscal year 2022 expenditures beginning
on January 15, 2022. The statute requires CMS to set up a data
collection system for all state supplemental payments. Form Number:
CMS-10398 (#73) (OMB control number: 0938-1148); Frequency: Yearly;
Affected Public: State, Local, or Tribal Governments; Number of
Respondents: 54; Total Annual Responses: 54; Total Annual Hours: 3,240.
(For policy questions regarding this collection contact: Richard
Kimball at 410-786-2278.)
4. Title of Information Collection: Coverage of Routine Patient
Cost for Items & Services in Qualifying Clinical Trials; Type of
Information Collection Request: New collection; Use: Section 210 of the
Consolidated Appropriations Act of 2021 amended section 1905(a) of the
Social Security Act (the Act) to add a new mandatory benefit at
1905(a)(30). The new benefit mandates coverage of routine patient
services and costs furnished in connection with participation by
Medicaid beneficiaries in qualifying clinical trials. Routine costs for
services provided in connection with participation in a qualifying
clinical trial generally include any item or service provided to the
individual under the qualifying clinical trial, including any item or
service provided to prevent, diagnose, monitor, or treat complications
resulting from participation in the qualified clinical trial, to the
extent that the provision of such items or services to the individual
would otherwise be covered under the state plan or waiver.
We propose that States and territories review the preprints
completed for a Medicaid beneficiary to receive coverage of routine
patient services and costs furnished in connection with participation
in qualifying clinical trials. Completion of the preprint pages
verifies in the Medicaid state plan that the mandatory clinical trials
benefit is being furnished by a state. Completion of the preprint
verifies that the requirements of a federally sponsored clinical trial
is appropriate for the Medicaid beneficiary. Form Number: CMS-10398
(#74) (OMB control number: 0938-1148); Frequency: Yearly; Affected
Public: State, Local, or Tribal Governments; Number of Respondents: 56;
Total Annual Responses: 56; Total Annual Hours: 56. (For policy
questions regarding this collection contact Kirsten Jensen at 410-786-
8146.)
5. Title of Information Collection: American Rescue Plan (ARP) 1135
State Plan Amendment; Type of Information Collection Request: New
collection; Use: Section 9811 of the ARP established new mandatory
benefits at section 1905(a)(4)(E) for COVID-19 vaccine and vaccine
administration and section 1905(a)(4)(F) for COVID-19 testing and
treatment for both Medicaid and CHIP. The effective date time period
for these mandatory benefits is March 11, 2021, ending on the last day
of the first calendar quarter that begins one year after the last day
of the emergency period described in section 1135(g)(1)(B) of the
Social Security Act (the Act). Given that regular state plan rules do
not allow for effective dates prior to the first day of the quarter in
which the state plan amendment (SPA) was submitted, we are allowing
states to use Section 1135 SPA process waiver authority to allow states
to meet the required timeframes of these provisions. The SPAs will
implement mandatory Medicaid coverage and reimbursement for COVID-19
vaccine and vaccine administration and COVID-19 testing and treatment
are considered part of the Agency's emergency response to COVID. CMS
has issued guidance for each of these provisions.
In large part, states have already been providing these services
throughout the course of the pandemic and these SPAs will reflect what
states have been doing. CMS is primarily using an attestation approach
for states to affirm that they are in compliance with the requirements
of the provisions.
Form Number: CMS-10398 (#75) (OMB control number: 0938-1148);
Frequency: Once and on occasion; Affected Public: State, Local, or
Tribal Governments; Number of Respondents: 56; Total Annual Responses:
56; Total Annual Hours: 168. (For policy questions regarding this
collection contact Kirsten Jensen at 410-786-8146.)
Dated: January 4, 2022.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2022-00119 Filed 1-6-22; 8:45 am]
BILLING CODE 4120-01-P
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