View Information Collection Request (ICR) Package
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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:
0938-1074
ICR Reference No:
202011-0938-013
Status:
Historical Active
Previous ICR Reference No:
201706-0938-002
Agency/Subagency:
HHS/CMS
Agency Tracking No:
OFM
Title:
Mandatory Insurer Reporting Requirements of Section 111 of the Medicare, Medicaid and SCHIP Act of 2007 (CMS-10265)
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:
01/18/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/09/2020
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2025
36 Months From Approved
01/31/2022
Responses
5,239,931
0
5,019,248
Time Burden (Hours)
618,060
0
485,826
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
US Code:
42 USC 1395y(b)(7)(A)(i)(II
Name of Law: Exclusions from coverage and medicare as secondary payer
PL:
Pub.L. 115 - 271 4002
Name of Law: Support Act
Citations for New Statutory Requirements:
PL: Pub.L. 115 - 271 4002 Name of Law: Support Act
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:
85 FR 58360
09/18/2020
30-day Notice:
Federal Register Citation:
Citation Date:
85 FR 78853
12/07/2020
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
5
IC Title
Form No.
Form Name
Mandatory Insurer Reporting (GHP-Private)
Mandatory Insurer Reporting (GHP-Private, Maintenance/Administrative)
Mandatory Insurer Reporting (NGHP-Private)
CMS-10625
Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, Private - Maintenance/Administration)
CMS-10265
Interim Non-GHP Record Layout
Mandatory Insurer Reporting for Prescription Drug (GHP RREs-Private, Maintenance/Administrative)
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
5,239,931
5,019,248
0
790
219,893
0
Annual Time Burden (Hours)
618,060
485,826
0
4,345
127,889
0
Annual Cost Burden (Dollars)
0
0
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:
Burden has increased due to multiple reasons. Beginning in January 2020 CMS started to collect prescription drug information per the requirements cited in Section 4002 of the SUPPORT Act and 42 U.S.C. 1395y(b)(7)(A)(i)(II) which also applies to the increase in the burden cost for GHPs. Burden has also increased due to the number increase of NGHP records and TPOCs received.
Annual Cost to Federal Government:
$19,166,000
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?
No
Agency Contact:
Stephan McKenzie 410 786-1943 stephan.mckenzie@cms.hhs.gov
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:
12/09/2020
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