View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-1053	ICR Reference No: 202107-0938-006
Status: Historical Active	Previous ICR Reference No: 201807-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: Administrative Requirements for Section 6071 of the Deficit Reduction Act of 2005 (CMS-10249)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/25/2021
	Date Received in OIRA: 07/22/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2024	36 Months From Approved	12/31/2021
Responses	336	0	352
Time Burden (Hours)	2,604	0	3,168
Cost Burden (Dollars)	0	0	0

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

IC Title	Form No.	Form Name
Administrative Requirements for Section 6071 of the DRA	CMS-10249, CMS-10249, CMS-10249, CMS-10249, CMS-10249, CMS-64.9i, -64.9pi, -64.10i, and -64.910pi,	, , , ,

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	336	352	-16
Annual Time Burden (Hours)	2,604	3,168	-564
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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This package aims to reduce the reporting burden on States by presenting a substantially revised and shorted version of the MFP Semi-Annual progress report. The MFP Budget Workbook has also been revised to combine two earlier reporting forms: the MFP Worksheet for Proposed Budget (WFPB) and Budget Narrative. As of March 2018, CMS had awarded 44 MFP grants. As of September 2020, two grantees withdrew from the MFP Program. Thus, burden estimates are for 41 states and the District of Columbia instead of 44 states used in the last submission. Overall, we estimate a reduction of 564 hours.

Annual Cost to Federal Government: $87,086

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]? Yes

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

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