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View ICR - OIRA Conclusion

OMB Control No: 0938-0829	ICR Reference No: 201907-0938-001
Status: Historical Active	Previous ICR Reference No: 201702-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Notice of Denial of Medical Coverage (or Payment) (NDMCP) (CMS-10003)
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: 02/07/2020
	Date Received in OIRA: 07/17/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2023	36 Months From Approved	02/29/2020
Responses	9,373,200	0	7,050,602
Time Burden (Hours)	1,561,575	0	1,174,630
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	9,373,200	7,050,602	2,322,598
Annual Time Burden (Hours)	1,561,575	1,174,630	386,945
Annual Cost Burden (Dollars)	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: The slight increase in burden is, in part, due to the increase in the numbers of Medicare health plan enrollees and total number of organization determinations. Since 2014, the number of enrollees has risen from 16.2 million to 18.3 million and the total number of organization determinations increased from 405,455,838 to 498,366,788. As a result the annual hourly burden has increased in the burden to 1,561,575 hours. .

Annual Cost to Federal Government: $0

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: Stephan McKenzie 410 786-1943 stephan.mckenzie@cms.hhs.gov

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