View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-1000	ICR Reference No: 201912-0938-020
Status: Historical Active	Previous ICR Reference No: 201612-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Medicare Parts C and D Program Audit Protocols and Data Requests (CMS-10191)
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: 06/04/2020
	Date Received in OIRA: 01/07/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2023	36 Months From Approved	06/30/2020
Responses	207	0	241
Time Burden (Hours)	39,456	0	52,261
Cost Burden (Dollars)	0	0	0

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Medicare Parts C and D Program Audit Protocols and Data Requests	CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191, CMS-10191	, , , , , , , , , , , , , , , , , , , ,

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	207	241	-34
Annual Time Burden (Hours)	39,456	52,261	-12,805
Annual Cost Burden (Dollars)	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: No

Burden Reduction Due to:

Short Statement: Decrease in burden has occurred due to an estimate in responding sponsoring organizations that will will be subject to data collections and the number of responses. Within the 5 protocols, we removed columns within the universes that were no longer needed (e.g., to better align with regulatory changes) or to promote consistency across the program-area instructions. We also removed several CDAG and ODAG universes entirely, renumbered the remaining CDAG universes and removed duplicative or unnecessary SNP-MOC compliance standards. Finally, we added a SNPMOC questionnaire to this collection request.

Annual Cost to Federal Government: $7,637,934

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? No

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

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