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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-1155
ICR Reference No:
202308-0938-015
Status:
Active
Previous ICR Reference No:
202209-0938-002
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CCIIO
Title:
Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment (CMS-10401)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
04/02/2024
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/01/2023
Terms of Clearance:
Prior to the re-submission of this information collection (IC), CMS has agreed to modify it to incorporate the administrative appeal process to address unresolved discrepancies for the premium stabilization programs under § 156.1220 and associated guidance, as well as any assessment under §153.740(b) of a default risk adjustment charge. As clarified during the 2023/2024 review of this package, the 5 CFR 1320.4(a)(2) PRA exemption is not universally applicable to this appeal process and, therefore, this appeal process must be properly accounted for.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
04/30/2025
36 Months From Approved
08/31/2025
Responses
3,250
0
3,250
Time Burden (Hours)
4,154,150
0
4,126,850
Cost Burden (Dollars)
0
0
0
Abstract:
The reinsurance program, risk corridors program, and risk adjustment program support the effective functioning of the American Health Benefit Exchanges ("Exchanges"), which will become operational by January 1, 2014. The program also mitigate the negative impacts of adverse selection and market uncertainty.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 1321; 1341; 1342; 1343
Name of Law: Affordable Care Act
Citations for New Statutory Requirements:
US Code: 45 USC 153 Name of Law: STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
88 FR 31759
05/18/2023
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 56023
08/17/2023
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
5
IC Title
Form No.
Form Name
Claim In-Network or Out-of-Network Indicator
Respond to the final distributed data report
Risk adjustment distributed data collection
Supplemental Diagnosis
Upload of Risk Adjustment and Reinsurance Data for Masked Enrollee Identification Number
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
3,250
3,250
0
0
0
0
Annual Time Burden (Hours)
4,154,150
4,126,850
27,300
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
This revision includes a slight increase (+27,300) in burden from approximately 4,126,850 hours to 4,154,150 hours, due to the additional collection and extraction of six (6) new EDGE data elements in for the Risk Adjustment and Reinsurance data collection (Appendix A).
Annual Cost to Federal Government:
$67,045,896
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Jamaa Hill 301 492-4190
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
09/01/2023
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