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:
0938-1054
ICR Reference No:
201105-0938-008
Status:
Historical Active
Previous ICR Reference No:
200810-0938-009
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516 (a)
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:
12/20/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/23/2011
Terms of Clearance:
CMS continues to agree to include the technical specifications document in the ICR package and to make it available to the public during the public comment periods. ICR packages that do not contain this information and were not made available for public comment will be considered incomplete. CMS also understands that all burden-impacting changes--even technical changes like procedure and diagnosis codes that are revised annually--are subject to the PRA and require an opportunity for public comment before they are implemented. This includes changes that would require respondents to change their workflow processes or computer programs in order to accommodate those changes.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2014
36 Months From Approved
12/31/2011
Responses
8,445
0
12,709
Time Burden (Hours)
208,920
0
286,944
Cost Burden (Dollars)
0
0
0
Abstract:
The collection forces MA organizations to develop, compile, evaluate, and report to CMS, to its enrollees, and to the general public, as required by CMS' regulatory authority, which establishes reporting requirements (to ensure effective monitoring) for Part C Medicare Advantage.
Authorizing Statute(s):
PL:
Pub.L. 110 - 275 164
Name of Law: MIPPA
Citations for New Statutory Requirements:
None
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:
75 FR 79000
12/17/2010
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 19775
04/08/2011
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516 (a) - (CMS-10261)
CMS-10261, CMS-10261, CMS-10261
Attachment I - Part C Reporting Overview
,
Attachment III - Medicare Advantage Medical Utilization and Expenditure Experience
,
Medicare Part C Reporting Requirements
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
8,445
12,709
0
-4,264
0
0
Annual Time Burden (Hours)
208,920
286,944
0
-78,024
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
There is a decrease in cost and hour burden. One measure was added and another was enhanced, but these costs are more than offset by the suspension of two measures and the decrease in reporting frequency of some measures.
Annual Cost to Federal Government:
$300,000
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]?
No
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?
Uncollected
Agency Contact:
William Parham 4107864669
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:
05/23/2011
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