Notice2025-18448
Agency 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
September 24, 2025
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
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 60 days for public comment on the proposed action. Interested persons are invited to send 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 183 (Wednesday, September 24, 2025)</title>
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[Federal Register Volume 90, Number 183 (Wednesday, September 24, 2025)]
[Notices]
[Pages 45939-45941]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-18448]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10718, CMS-10611 and CMS-10260]
Agency 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: 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 60 days for public comment on
the proposed action. Interested persons are invited to send 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
[[Page 45940]]
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 November 24, 2025.
ADDRESSES: When commenting, please reference the document identifier or
OMB control number. 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: Document Identifier:
__/OMB Control Number: __, 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/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing">https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing</a>.
FOR FURTHER INFORMATION CONTACT: William N. Parham at (410) 786-4669.
SUPPLEMENTARY INFORMATION:
Contents
This notice sets out a summary of the use and burden associated
with the following information collections. More detailed information
can be found in each collection's supporting statement and associated
materials (see ADDRESSES).
CMS-10718--Model Medicare Advantage and Medicare Prescription Drug Plan
Individual Enrollment Request Form
CMS-10611--Medicare Outpatient Observation Notice (MOON)
CMS-10260--Medicare Advantage and Prescription Drug Program
Under the 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 requires federal agencies
to publish a 60-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.
Information Collections
1. Type of Information Collection Request: Revision with of a
currently approved collection; Title of Information Collection: Model
Medicare Advantage and Medicare Prescription Drug Plan Individual
Enrollment Request Form; Use: The enrollment form is considered a
``model'' under Medicare regulations at Sec. Sec. 422.2267 and
423.2267, for purposes of communication and marketing review and
approval; therefore, MA and Part D plans are able to modify the
language, format, or order of the enrollment form. The model enrollment
form includes the minimal amount of information to process the
enrollment, located in Section 1 of the MA/PDP enrollment form, and
other limited information, in Section 2, that the sponsor is required
(i.e., accessible format preference) or chooses (i.e., premium payment
information) to provide to the beneficiary. The optional data elements,
which aids the MA and Part D plan in processing the enrollment, is
developed for efficiency for the plan. Plan sponsors can obtain
information at the initial point of contact to help streamline the
beneficiary's enrollment process. The optional questions include
information specific to the plan's business needs that serves to reduce
overall burden and allow for timely processing of an enrollment
request. All data elements in Section 2 are optional for the
beneficiary to complete. Plan enrollment will not be affected if the
beneficiary does not complete this additional information. Form Number:
CMS-10718 (OMB control number 0938-1378); Frequency: Occasionally;
Affected Public: Individuals and Households, Private sector and
Business or other for-profits; Number of Respondents: 24,464,437;
Number of Responses: 49,917,959; Total Annual Hours: 12,240,174. (For
questions regarding this collection, contact: AnhViet Nguyen at (667)
290-9745 or <a href="/cdn-cgi/l/email-protection#dfbeb1b7a9b6baabf1b1b8aaa6bab19fbcb2acf1b7b7acf1b8b0a9"><span class="__cf_email__" data-cfemail="ccada2a4baa5a9b8e2a2abb9b5a9a28cafa1bfe2a4a4bfe2aba3ba">[email protected]</span></a>).
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Hospital Notice:
Medicare Outpatient Observation Notice (MOON); Use: The Medicare
Outpatient Observation Notice (MOON), serves as the written notice
component of this mandatory notification process. The standardized
content of the MOON includes all informational elements required by
statute, in language understandable to beneficiaries, and fulfils the
regulatory requirements at 42 CFR part 489.20(y).
The MOON is a standardized notice delivered to people entitled to
Medicare benefits under Title XVIII of the Act who receive more than 24
hours of observation services, informing them that their hospital stay
is outpatient and not inpatient, and the implications of being an
outpatient. Form Number: CMS-10611 (OMB control number 0938-1308);
Frequency: Annually; Affected Public: Private sector, Business or other
for-profits and Not-for-profits institutions; Number of Respondents:
5,817; Number of Responses: 2,073,991; Total Annual Hours: 518,498.
(For questions regarding this collection, contact: Katherine Hosna at
410-786-4993 or <a href="/cdn-cgi/l/email-protection#f6bd97829e93849f9893d8be99859897b6959b85d89e9e85d8919980"><span class="__cf_email__" data-cfemail="80cbe1f4e8e5f2e9eee5aec8eff3eee1c0e3edf3aee8e8f3aee7eff6">[email protected]</span></a>).
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare
Advantage and Prescription Drug Program; Use: CMS requires MA
organizations and Part D sponsors to use the standardized documents
being submitted for OMB approval to satisfy disclosure requirements
mandated by section 1851 (d)(3)(A) of the Act and Sec. 422.111 for MA
organizations and section 1860D-1(c) of the Act and Sec. 423.128(a)(3)
for Part D sponsors.
The regulatory provisions at Sec. Sec. 422.111(b) and 423.128(b)
require MA organizations and Part D sponsors to disclose plan
information, including: service area, benefits, access, grievance and
appeals procedures, and quality improvement/assurance requirements. MA
organizations and sponsors may send the ANOC separately from the EOC
but must send the ANOC for enrollee receipt by September 30. The
required due date for the EOC is 15 days prior to the start of the AEP.
Form Number: CMS-10260 (OMB control number 0938-1051); Frequency:
Annually; Affected Public: Private sector and Business or other for-
profits; Number of Respondents: 712; Number of Responses: 45,996; Total
Annual Hours: 12,316. (For questions regarding this collection,
contact: Lauren Yeary at
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(410) 786-3211 or <a href="/cdn-cgi/l/email-protection#b2ded3c7c0d7dc9cd6c7ded3cbf2d1dfc19cdadac19cd5ddc4"><span class="__cf_email__" data-cfemail="365a57434453581852435a574f76555b45185e5e4518515940">[email protected]</span></a>).
William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts,
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2025-18448 Filed 9-23-25; 8:45 am]
BILLING CODE 4120-01-P
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