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View ICR - OIRA Conclusion

OMB Control No: 0938-1326	ICR Reference No: 201802-0938-007
Status: Historical Active	Previous ICR Reference No: 201610-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: The PACE Organization Application Process in 42 CFR Part 460 (CMS-10631)
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: 12/06/2018
	Date Received in OIRA: 03/01/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2021	36 Months From Approved	03/31/2020
Responses	109	0	89
Time Burden (Hours)	7,226	0	4,576
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	109	89	10	10
Annual Time Burden (Hours)	7,226	4,576	1,810	840
Annual Cost Burden (Dollars)	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: However, CMS has reconsidered its approach to the application process specific to SAEs and therefore, in addition to certain minor tweaks, is making modifications to the application and the requirements for application submission. The number of SAE applications submitted to CMS for approval has increased over time, and 35 SAE applications, on average, are now expected to be submitted annually. Details regarding the revisions, as well as the rationale for those changes, are provided below in sections 1, 8, and 15 of the Supporting Statement.

Annual Cost to Federal Government: $172,341

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]? 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: Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov

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