Notice2025-20367
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
November 20, 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 222 (Thursday, November 20, 2025)</title>
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[Federal Register Volume 90, Number 222 (Thursday, November 20, 2025)]
[Notices]
[Pages 52408-52409]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-20367]
[[Page 52408]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10142, CMS-10691, CMS-10463, CMS-10493, and
CMS-10507]
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 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 20, 2026.
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).
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 of a currently
approved collection; Title of Information Collection: Bid Pricing Tool
(BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans
(PDP); Use: 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 CMS.
The MAOs and PDPs use the Bid Pricing Tool (BPT) software to develop
their actuarial pricing bid. The competitive bidding process defined by
the ``The Medicare Prescription Drug, Improvement, and Modernization
Act'' (MMA) applies to both the MA and Part D programs. It is an annual
process that encompasses the release of the MA rate book in April, the
bid's that plans submit to CMS in June, and the release of the Part D
and RPPO benchmarks, which typically occurs in August. Form Number:
CMS-10142 (OMB control number: 0938-0944); Frequency: Annually;
Affected Public: Private Sector, Business or other for profits, and Not
for profits institutions; Number of Respondents: 460; Total Annual
Responses: 11,700; Total Annual Hours: 406,000. (For questions
regarding this collection contact Rachel Shevland at 410-786-3026 or
<a href="/cdn-cgi/l/email-protection#481a292b202d24663b202d3e2429262c082b253b6620203b662f273e"><span class="__cf_email__" data-cfemail="164477757e737a38657e73607a77787256757b65387e7e6538717960">[email protected]</span></a>.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Data Request and
Attestation for PDP Sponsors; Use: Section 50354 of the BBA requires
that the Secretary establish a process for PDP sponsors to submit a
request for standardized extracts of claims data for their enrollees.
In addition, Section 50354 of the BBA provides for a number of purposes
and limitation for the use of the claims data and also permits the
Secretary to establish other limitations necessary to protect the
identity of individuals entitled to or enrolled in Medicare, and to
protect the security of personal health information.
This information collection request allows a PDP sponsor to submit
a request to CMS for claims data for its enrollees and to attest that
it will adhere to the permitted uses and limitations on the use of the
Medicare claims data that are listed in 42 CFR 423.153(g)(3) and After
requesting claims data for its enrollees and attesting to the permitted
uses and limitations of Medicare claims data, PDP sponsors are required
to complete some basic on-boarding activities before gaining access to
Medicare claims data using the Part A and B Claims Data to Part D
Sponsors (AB2D) API. Form Number: CMS-10691 (OMB control number: 0938-
1371); Frequency: Annually; Affected Public: Private Sector, Business
or other for profits, and Not for profits institutions; Number of
Respondents: 200; Total Annual Responses: 200; Total Annual Hours:
36.83. (For questions regarding this collection contact Kari Gaare at
410-786-8612 or <a href="/cdn-cgi/l/email-protection#541f35263d7a3335352631143739277a3c3c277a333b22"><span class="__cf_email__" data-cfemail="83c8e2f1eaade4e2e2f1e6c3e0eef0adebebf0ade4ecf5">[email protected]</span></a>.)
3. Type of Information Collection Request: Reinstatement with
change of a previously approved collection; Title of Information
Collection: Cooperative Agreement to Support Navigators in Federally-
facilitated Exchanges and State Partnership Exchanges; Use: Section
1311(i) of the ACA requires Exchanges to establish a Navigator program
under which it awards grants
[[Page 52409]]
to eligible individuals and entities, as described in Section
1311(i)(2) of the ACA and 45 CFR 155.210(a) and (c), to carry out
certain Navigator duties in states with an FFE. Entities or individuals
that receive a cooperative agreement award must be capable of carrying
out, at a minimum, all Navigator duties required by the ACA and HHS
regulations. The primary regulations that establish requirements for
Navigator grant awardees are 45 CFR 155.210 and 155.215. Under the
terms and conditions of the Navigator program cooperative agreements,
awardees must provide progress reports on a weekly, monthly, and
quarterly basis, and a final report at the end of the five-year period
of performance. Form Number: CMS-10463 (OMB control number: 0938-1215);
Frequency: Annually, Monthly, Quarterly, Weekly; Affected Public:
Private Sector; Businesses or other for-profits, Not-for-profit
institutions; Number of Respondents: 44; Total Annual Responses:
120,236; Total Annual Hours: 457,857. (For questions regarding this
collection contact Gian Johnson at 301-492-4323.)
4. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Data Collection
to Support Eligibility Determinations for Small Businesses in the Small
Business Health Options Program; Use: On March 23, 2010, the President
signed into law H.R. 3590, the Patient Protection and Affordable Care
Act, Public Law 111-148, as amended by the Health Care and Education
Reconciliation Act of 2010, Public Law 111-152. The Patient Protection
and Affordable Care Act (PPACA) expands access to health insurance
coverage through improvements to the Medicaid and Children's Health
Insurance (CHIP) programs, the establishment of Affordable Insurance
Exchanges (Exchanges), and the coordination between Medicaid, CHIP, and
Exchanges. Small business employers may participate in and provide
health coverage through the Small Business Health Options Program
(SHOP), so long as the small business employer obtains a positive
eligibility determination from SHOP. Employers will work with SHOP-
registered agents/brokers or Issuers offering Qualified Health Plans
(QHPs) and Qualified Dental Plans (SADPs), to enroll in SHOP coverage
and to select coverage options to offer their employees. SHOP Exchanges
became operational on October 1, 2013.
HHS has developed a single, streamlined form that employers use to
obtain a SHOP eligibility determination, which is included as an
appendix to this Information Collection Request. 45 CFR 155.731
provides more detail about this ``single employer application,'' which
is used to determine employer eligibility. Since publication of the
last package, no updates have been made in regulation concerning what
information should be collected on the single employer application to
determine employer eligibility under 45 CFR 155.731. When an employer
completes the SHOP Eligibility Determination Form, the form and its
results are retained by SHOP for future use, if needed (e.g.,
reconciliation with issuer records, SHOP employer appeals, etc.). Form
Number: CMS-10439 (OMB control number: 0938-1193); Frequency: Annually;
Affected Public: Private Sector--Business or other for-profits, Not-
for-profit institutions; Number of Respondents: 2,100; Number of
Responses: 2,100; Total Annual Hours: 336. (For questions regarding
this collection, contact Mary Guy at 410-786-2772).
5. Type of Information Collection Request: Reinstatement with
change of a previously approved information collection; Title of
Information Collection: State-based Exchange Annual Reporting Tool
(SMART); Use: The ACA Sec. 1313(a)(1) and its implementing regulations
require State Exchanges to keep an accurate accounting of all
activities, receipts, and expenditures, and to submit a report annually
to CMS concerning such accounting. Instructions governing specific
facets of the activities covered by the report are contained both in
the ACA and 45 CFR 155.1200, 155.1210. CMS uses the SMART as the
reporting tool to ensure compliance with regulatory requirements.
CMS uses the information collected from the SMART to determine if a
state is maintaining a compliant, operational Exchange. It also
provides a mechanism to collect innovative approaches to meeting
challenges encountered by states during the preceding year, as well as
to provide information to CMS regarding potential changes in priorities
and approaches for the upcoming year. If CMS determines a state to be
non-compliant through the review of required documentation, it will
issue a formal letter asking the state to develop and submit a
Corrective Action Plan (CAP). CMS may also provide technical assistance
to help State Exchanges address potential areas of non-compliance, as
needed. Form Number: CMS-10507 (OMB control number: 0938-1244);
Frequency: Annually; Affected Public: State, Local or Tribal
Government; Number of Respondents: 23; Number of Responses: 23; Total
Annual Hours: 4,792. (For questions regarding this collection, contact
Tiffany Y. Animashaun at <a href="/cdn-cgi/l/email-protection#52063b3434333c2b7c133c3b3f33213a33273c12313f217c3a3a217c353d24"><span class="__cf_email__" data-cfemail="83d7eae5e5e2edfaadc2edeaeee2f0ebe2f6edc3e0eef0adebebf0ade4ecf5">[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. 2025-20367 Filed 11-19-25; 8:45 am]
BILLING CODE 4120-01-P
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