View Information Collection Request (ICR) Package
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View Supporting Statement and Other Documents
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:
0960-0707
ICR Reference No:
200812-0960-011
Status:
Historical Active
Previous ICR Reference No:
200708-0960-007
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Medicare Subsidy Quality Review Case Analysis
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
02/20/2009
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/31/2008
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/29/2012
36 Months From Approved
11/30/2010
Responses
34,000
0
74,500
Time Burden (Hours)
8,085
0
18,625
Cost Burden (Dollars)
0
0
0
Abstract:
The Medicare Modernization Act of 2003 mandated the creation of the Medicare Part D prescription drug coverage program and provided for certain subsidies for eligible Medicare beneficiaries to help pay for the costs of prescription drugs. As part of its stewardship duties of the Medicare Part D subsidy program, SSA must conduct periodic quality review checks of the information Medicare beneficiaries report on their subsidy applications (Form SSA-1020). SSA uses the Medicare Quality Review program to conduct these checks. Beginning in January 2010, SSA will revise the Medicare Quality Review system to comply with P.L. 110-275. Specifically, we will: 1) Eliminate the use of Form SSA-9309, the Life Insurance Verification form; and 2) remove any questions about life insurance policy values and in-kind support and maintenance from the other forms in the collection. This ICR is for the revised Medicare Quality Review System, which we will not use until January 2010. The respondents are applicants for the Medicare Part D subsidy whom we have chosen to undergo a Quality Review.
Authorizing Statute(s):
US Code:
42 USC 1395w-114
Name of Law: Social Security Act
PL:
Pub.L. 110 - 275 100
Name of Law: Medicare Improvements for Patients and Providers Act of 2008
Citations for New Statutory Requirements:
PL: Pub.L. 110 - 275 100 Name of Law: Medicare Improvements for Patients and Providers Act of 2008
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:
73 FR 64004
10/28/2008
30-day Notice:
Federal Register Citation:
Citation Date:
73 FR 79537
12/29/2008
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
10
IC Title
Form No.
Form Name
SSA-8510
SSA-8510
Authorization for the Social Security Administration to Obtain Personal Information
SSA-9301
SSA-9302
SSA-9302
Notice of Appointment - Reviewer Will Call
SSA-9303
SSA-9303
Notice of Appointment-Please Call Reviewer
SSA-9308
SSA-9308
Request for Release of Information
SSA-9309
SSA-9309
Life Insurance Verification
SSA-9310
SSA-9310
Request for Documents
SSA-9311
SSA-9311
Notice of Appointment -Denial- Reviewer Will Call
SSA-9312
SSA-9312
Notice of Appointment -Denial- Please Call Reviewer
SSA-9313
SSA-9313
Notice of Quality Review Acknowledgement Form for those with Phones
SSA-9314
SSA-9314
Notice of Quality Review Acknowledgement Form for those without Phones
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
34,000
74,500
0
-8,000
-32,500
0
Annual Time Burden (Hours)
8,085
18,625
0
-2,416
-8,124
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:
Yes
Burden Reduction Due to:
Changing Regulations
Short Statement:
Burden reduction due to 1)decreased number of respondents (adjustment) and 2) elimination of certain questions and 1 form (SSA-9308) due to provisions of P.L. 110-275.
Annual Cost to Federal Government:
$220,200
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
John Biles 410 965-3758 John.Biles@ssa.gov
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:
12/31/2008
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