Federal Register/Vol. 85, No. 250/Wednesday, December 30, 2020/Notices

86568 Federal Register / Vol. 85, No. 250 / Wednesday, December 30, 2020 / Notices Information Collection: State descriptive term, as well as other 2010), is republished to realign Permissions for Enrollment in Qualified relevant factors such as location of functions in the Center for Program Health Plans in the Federally-Facilitated service, facility name, or dosage. In Integrity (CPI). Exchange & Non-Exchange Entities; Use: addition, the final rules require that the CPI is the focal point for all national On March 23, 2010, the Patient tool allow the user to refine and reorder and State-wide Medicare and Medicaid Protection and Affordable Care Act search results based on geographic programs and integrity fraud and abuse (PPACA; Pub. L. 111–148) was signed proximity of in-network providers. For issues related to the Children’s Health into law and on March 30, 2010, the covered items and services provided by Insurance Program (CHIP). It promotes Health Care and Education out-of-network providers, the tool must the integrity of the Medicare and Reconciliation Act of 2010 (Pub. L. 111– provide the out-of-network allowed Medicaid programs and CHIP through 152) was signed into law. The two laws amount, percentage of billed charges, or provider/contractor audits, policy implement various health insurance other rates that provide a reasonably reviews, identification and monitoring policies. accurate estimate of the amount a plan of program vulnerabilities, and provides This information collection request or issuer will pay by allowing support and technical assistance to (ICR) serves as the renewal of the data consumers to input a billing code, States. In addition, it recommends collection clearance related to the descriptive code, or other relevant modifications to programs and ability of states to permit agents and factor, such as location. operations as necessary and works with brokers, as well as Web-brokers, to assist The final rules also require plans and CMS Centers, Offices, and the Chief qualified individuals, qualified issuers to publicly disclose applicable Operating Officer to affect changes as employers, or qualified employees rates with in-network providers, appropriate, and collaborates with the enrolling in Qualified Health Plans in including negotiated rates; historical Office of Legislation on the the Federally Facilitated Exchange (45 data outlining the different billed development and advancement of new CFR 155.220) and data collection charges and allowed amounts a plan or legislative initiatives and improvements requirements related to non-exchange issuer has paid for covered items or to deter, reduce, and eliminate fraud, entities. (45 CFR 155.260). [All services, including prescription drugs, waste and abuse. references to § 155.220 shall mean 45 furnished by out-of-network providers; Part F, Section FC. 20 (Functions) is CFR 155.220.] Form Number: CMS– and negotiated rates and historical net as follows: 10650; Frequency: Annually; Affected prices for covered prescription drugs Center for Program Integrity Public: Private Sector, State, Business, furnished by in-network providers • and Not-for Profits; Number of through three machine-readable files (an Serves as CMS’ focal point for all Respondents: 55,148; Number of In-network Rate File, Allowed Amount national and State-wide Medicare and Responses: 55,148; Total Annual Hours: File, and Prescription Drug File). The Medicaid programs and CHIP integrity 272,707. (For questions regarding this machine-readable files must be posted fraud and abuse issues. • Promotes the integrity of the collection, contact Michele Oshman at publicly on an internet website and Medicare and Medicaid programs and (301–492–4407). updated on a monthly basis. Form CHIP through provider/contractor audits 2. Type of Information Collection Number: CMS–10715 (OMB control and policy reviews, identification and Request: New collection (Request for a number 0938–1372); Frequency: monitoring of program vulnerabilities, new OMB control number); Title of Frequently; Affected Public: Public and and providing support and assistance to Information Collection: Transparency in Private sectors; Number of Respondents: States. Recommends modifications to Coverage; Use: The final rules titled 908; Total Annual Responses: 74,460; programs and operations as necessary ‘‘Transparency in Coverage,’’ published Total Annual Hours: 28,618,546. (For and works with CMS Centers, Offices, November 12, 2020 (85 FR 72158), policy questions regarding this and the Chief Operating Officer (COO) establish requirements for group health collection contact Russell Tipps at 301– plans and health insurance issuers to affect changes as appropriate. 492–4371). offering non-grandfathered coverage in Collaborates with the Office of the individual and group markets to Dated: December 23, 2020. Legislation on the development and disclose to a participant, beneficiary, or William N. Parham, III, advancement of new legislative enrollee (or an authorized representative Director, Paperwork Reduction Staff, Office initiatives and improvements to deter, on behalf of such individual) the of Strategic Operations and Regulatory reduce, and eliminate fraud, waste and consumer-specific estimated cost- Affairs. abuse. sharing liability for covered items or [FR Doc. 2020–28851 Filed 12–29–20; 8:45 am] • Oversees all CMS interactions and services from a particular provider, BILLING CODE 4120–01–P collaboration with key stakeholders thereby allowing a participant, relating to program integrity (i.e., U.S. beneficiary, or enrollee to obtain an Department of Justice, DHHS Office of accurate estimate and understanding of DEPARTMENT OF HEALTH AND Inspector General, State law their potential out-of-pocket expenses HUMAN SERVICES enforcement agencies, other Federal and to effectively shop for covered items entities, CMS components) for the and services. Plans and issuers are Centers for Medicare & Medicaid purposes of detecting, deterring, required to make such information Services monitoring and combating fraud and available for covered items and services Statement of Organization, Functions, abuse, as well as taking action against through an internet-based self-service and Delegations of Authority those that commit or participate in tool, and, if requested, in paper form. fraudulent or other unlawful activities. The internet-based self-service tool must Part F of the Statement of • In collaboration with other CMS allow participants, beneficiaries, or Organization, Functions, and Centers, Offices, and the COO, develops enrollees to search for cost-sharing Delegations of Authority for the and implements a comprehensive information for a covered item or Department of Health and Human strategic plan, objectives and measures service by inputting the name of a Services, Centers for Medicare & to carry out CMS’ Medicare, Medicaid specific in-network provider in Medicaid Services (CMS) (last amended and CHIP program integrity mission and conjunction with a billing code or at 75 FR 14176–14178, dated March 24, goals, and ensure program VerDate Sep<11>2014 17:47 Dec 29, 2020 Jkt 253001 PO 00000 Frm 00040 Fmt 4703 Sfmt 4703 E:\FR\FM\30DEN1.SGM 30DEN1 Federal Register / Vol. 85, No. 250 / Wednesday, December 30, 2020 / Notices 86569 vulnerabilities are identified and (SYSIL) will build evidence on how to information collection request includes resolved. end homelessness among youth and the baseline and follow-up survey Authority: 44 U.S.C. 3101. young adults with experience in the instruments for the impact study (a child welfare system by continuing single instrument administered four The Administrator of the Centers for work with an organization who times), and discussion guides for Medicare & Medicaid Services (CMS), conducted foundational work as part of interviews and focus groups and the Seema Verma, having reviewed and the Youth At-Risk of Homelessness Working Alliance Inventory (WAI) for approved this document, authorizes project (OMB Control Number: 0970– the implementation study. The data Lynette Wilson, who is the Federal 0445). SYSIL will provide important collected from the baseline and follow- Register Liaison, to electronically sign information to the field by designing this document for purposes of up surveys will be used to describe the and conducting a federally led publication in the Federal Register. characteristics of the study sample of evaluation of a comprehensive service youth, develop models for estimating Dated: December 22, 2020. model for youth at risk of homelessness. program impacts, and determine Lynette Wilson, DATES: Comments due within 60 days of program effectiveness by comparing Federal Register, Centers for Medicare & publication. In compliance with the outcomes between youth in the Medicaid Services. requirements of Section 3506(c)(2)(A) of treatment (youth receiving the Pathways [FR Doc. 2020–28795 Filed 12–28–20; 8:45 am] the Paperwork Reduction Act of 1995, program) and control groups. Data from BILLING CODE 4120–01–P ACF is soliciting public comment on the the interviews and focus groups will specific aspects of the information provide a detailed understanding of collection described above. program implementation. The study DEPARTMENT OF HEALTH AND will also use administrative data from HUMAN SERVICES ADDRESSES: Copies of the proposed collection of information can be the child welfare system, homelessness Administration for Children and obtained and comments may be management information system, and Families forwarded

Load more