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OMB Control No: 0938-1074	ICR Reference No: 201706-0938-002
Status: Historical Active	Previous ICR Reference No: 201309-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No: CMS-10265
Title: Mandatory Insurer Reporting Requirements of Section 111 of the Medicare, Medicaid and SCHIP Act of 2007 (CMS-10265)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/26/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/28/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2021	36 Months From Approved	02/28/2017
Responses	5,019,248	0	230,449
Time Burden (Hours)	485,826	0	82,782
Cost Burden (Dollars)	0	0	0

Abstract: The Centers for Medicare & Medicaid Services (CMS) seeks to collect various data elements for the applicable reporting entities for purpose of implementing the mandatory MSP reporting requirements of Section 111 of the MMSEA. This information will be used to ensure that Medicare makes payment in the proper order and/or takes necessary recovery actions. The purpose of this submission is to set forth what information will be collected pursuant to Section 111 and the process for such collection. Section 111 mandates the reporting of information specified by the Department of Health and Human Services Secretary in the form and manner specified by the Secretary (including frequency) Data the Secretary will collect is necessary for both pre-payment and post-payment coordination of benefit purposes, including the recovery actions. Section 111 establishes separate mandatory reporting requirements for group health plan arrangements as well as for liability insurance (including self-insurance), no-fault insurance, and workers' compensation, also referred to as non-group health plan. With the passage of Section 111, CMS now has the authority to mandate the reporting of insurer MSP information.

Authorizing Statute(s): PL: Pub.L. 110 - 173 111 Name of Law: Medicare Secondary Payer (MSP) Mandatory Insurer Reporting Requirements

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:
	82 FR 3325	01/11/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 28065	06/20/2017
Did the Agency receive public comments on this ICR? No

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	5,019,248	230,449	-483,280	-1,147,671	6,419,750
Annual Time Burden (Hours)	485,826	82,782	-40,272	-405,199	848,515
Annual Cost Burden (Dollars)	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: Cutting Redundancy

Short Statement: There are three reasons why GHP burden has been reduced. First, GHP set-up of reporting has been completed and they are only incurring administrative costs to support ongoing reporting.The sources of the data are now limited to just private insurers. Same amount of data as before, but no longer expect to collect it from so many different groups such as fed and state govts. Insurers provide all of the data. Second, since the Section 111 reporting requirements were first implemented, there was an initial burden on the GHPs to report all outstanding information on their initial files. The number of records being reported now only includes maintenance of old records plus any new records that need to be reported. Therefore, the total volume of record transactions has been reduced from 3.7 million per year to 2.6 million per year. Third, through industry consolidation, the total number of GHPs that report to CMS has been reduced from 1650 to 1154. This consolidation of resources resulted in fewer duplicative administrative costs. There are four reasons why NGHP burden has been reduced. First, NGHP set-up of reporting has been completed and they are only incurring administrative costs to support ongoing reporting. Second, since the Section 111 reporting requirements were first implemented, there was an initial burden on the NGHPs to report all outstanding information on their initial files. The number of records being reported now only includes maintenance of old records plus any new records that need to be reported. Therefore, the total volume of record transactions has been reduced from 2.9 million per year to 2.4 million per year. Third, for the majority of reporting NGHPs, that are also very small, low volume reporters, CMS developed a simplified reporting process called the Direct Data Entry process that allows the bulk of NGHPs to use a web portal to manually report data, These small entities do not have to incur the higher costs of setting up and maintaining a system to system interface with CMS that only the very largest NGHPs find more cost effective for their reporting. However, the decrease in NGHP burden was only slight because the large number of low volume reporters using the manual Direct Data Entry process are not realizing the economies of scale that the few large NGHP insurers achieved. The larger insurers initially invested in setting up electronic file exchange systems with CMS, so their burden has decreased while, for the bulk of smaller NGHP reporters, hourly burden has remained more constant. Fourth, through industry consolidation, the total number of NGHPs that report to CMS has been reduced from 21,091 to 18,114. The original estimated burden included potential reporting by state and local governments and federal agencies, as self-insured entities. In practice, private insurers are reporting data that includes data related to these government groups. This consolidation of resources and data reporting streams resulted in fewer duplicative administrative costs for NGHPs and the removal of burden estimates for state and local governments and federal agencies.

Annual Cost to Federal Government: $10,000,000

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. Yes

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. Yes

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: Kayla Williams 410 786-5887 Kayla.Williams@cms.hhs.gov

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