Notice2025-01022
Medicaid and Children's Health Insurance Program (CHIP) Generic Information Collection Activities: Proposed Collection; Comment Request
Primary source
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Published
January 16, 2025
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 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. 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 90 Issue 10 (Thursday, January 16, 2025)</title>
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[Federal Register Volume 90, Number 10 (Thursday, January 16, 2025)]
[Notices]
[Pages 4744-4745]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-01022]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-10398 #87, #90, and #91]
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 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. 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.
DATES: Comments must be received by January 30, 2025.
[[Page 4745]]
ADDRESSES: When commenting, please reference the applicable form number
(CMS-10398 #___) 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 #___/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, please access
the CMS PRA website by copying and pasting the following web address
into your web browser: <a href="https://www.cms.gov/medicare/regulations-guidance/legislation/paperwork-reduction-act-1995/pra-listing">https://www.cms.gov/medicare/regulations-guidance/legislation/paperwork-reduction-act-1995/pra-listing</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 Collection
1. Title of Information Collection: Managed Care Plan (MCP) Medical
Loss Ratio (MLR) Reporting Template; Type of Information Collection
Request: New collection of information request; Use: Medicaid managed
care is the predominant delivery system for Medicaid beneficiaries to
access health care services. State Medicaid agencies contract with
managed care plans (MCPs) that accept a fixed, prospective monthly
payment for each enrolled beneficiary (also referred to as risk-based
managed care). Section 1903(m)(2) of the Social Security Act and 42 CFR
438.4 require that capitation rates be actuarially sound, meaning that
the capitation rates are projected to provide for all reasonable,
appropriate, and attainable costs that are required under the terms of
the contract and for the operation of the MCP for the time period and
the population covered under the terms of the contract. The medical
loss ratio (MLR) is a key measure of MCP financial performance and
indicates the share of premium revenue (capitation payments) that a
plan spends on covered health services and activities to improve health
care quality compared to the share of revenue to cover administrative
expenses and profit/surplus. MLRs are used as a retrospective tool to
assess financial performance of MCPs. Section 438.8 provides detail on
MLR calculations and MCP reporting requirements.
Section 438.8(k) requires State contracts with MCPs to include a
requirement to annually report to the state specific details of the
plan's MLR. The attached Medicaid managed care plan MLR reporting
template provides States with a standard format for collecting the
required details from their contracted MCPs. States are not required to
have their MCPs use this template; it is provided in response to
States' requests for a streamlined, consistent way to collect the
required information. CMS' review process for managed care MLR
represents an essential Federal oversight function to ensure that
States and MCPs are compliant with applicable Federal laws and
regulations.
Form Number: CMS-10398 #87 (OMB control number: 0938-1148);
Frequency: Yearly; Affected Public: Private Sector and State, Local, or
Tribal Governments; Number of Respondents: 47; Total Annual Responses:
47; Total Annual Hours: 2,350. (For policy questions regarding this
collection contact: Amy Gentile at 410-786-3499.)
2. Title of Information Collection: CAA of 2024, Section 206
Planning Grant Reporting; Type of Information Collection Request: New
collection of information request; Use: This collection relates to
section 206(a) of the Consolidated Appropriations Act, 2024 (CAA of
2024), ``State Planning Grants to Promote Continuity of Care for
Medicaid and CHIP Beneficiaries Following Incarceration''. This four-
year, discretionary grant program supports state Medicaid agencies and
Children's Health Insurance Programs (CHIP) to develop the operational
capabilities to promote continuity of care for Medicaid-eligible
individuals who have been incarcerated. To ensure maximum state
flexibility and to reduce the reporting burden on states as much as
possible, states will submit semi-annual and final progress reports in
their preferred format. CMS will not require states to use a
standardized template or form, and CMS is not making an optional
template or form available for states to use. Form Number: CMS-10398
#90 (OMB control number: 0938-1148); Frequency: Semi-annually and once;
Affected Public: State, Local, or Tribal Governments; Number of
Respondents: 30; Total Annual Responses: 300; Total Annual Hours:
1,200. (For policy questions regarding this collection contact:
Jennifer Bowdoin at 410-786-8551.)
3. Title of Information Collection: State Plan Amendment (SPA)
Template for Medicaid Clinic Benefit; Type of Information Collection
Request: New information collection request information request; Use:
On November 27, 2024, CMS published the Prospective Payment System and
Ambulatory Surgical Center Payment System final rule (CMS-1809-FC, RIN
0938-AV35) which amended 42 CFR 440.90 to authorize Medicaid coverage
for clinic services furnished outside the ``four walls'' of their
clinic. The rule provided States with the authority to amend their
state plans and add additional coverage outside of the clinic to the
optional clinic benefit. We have developed and attached a new state
plan template to simplify the SPA development, submission, and review/
approval processes for states and CMS.
Completion of the template is mandatory for states that both cover
the clinic services benefit and cover tribal clinics to allow clinic
services to be provided outside of the clinic under the clinic services
benefit but will be available as an option for all states who wish to
use the template to amend their state plan clinic pages for general
updates.
Form Number: CMS-10398 #91 (OMB control number: 0938-1148);
Frequency: One-time and on occasion; Affected Public: State, Local, or
Tribal Governments; Number of Respondents: 56; Total Annual Responses:
56; Total Annual Hours: 1,400. (For policy questions regarding this
collection contact: Marlana Thieler at 410-786-6274.)
William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts,
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2025-01022 Filed 1-15-25; 8:45 am]
BILLING CODE 4120-01-P
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