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View ICR - OIRA Conclusion

OMB Control No: 0938-1326	ICR Reference No: 202204-0938-003
Status: Historical Active	Previous ICR Reference No: 202002-0938-002
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 without change	Conclusion Date: 10/21/2022
	Date Received in OIRA: 05/03/2022
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2025	36 Months From Approved	04/30/2023
Responses	109	0	109
Time Burden (Hours)	7,271	0	7,226
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	109	109	0
Annual Time Burden (Hours)	7,271	7,226	45
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 number of attestations associated with the most recent updated PACE rule resulted in an increase of required attestations, from approximately 175 to about 190. Therefore, instead of 15 hours associated with this part of the application (approximately 5 minutes per attestation (~ 190 total), we now estimate 16 hours to complete all attestations associated with the application. CMS added estimated burden associated with the completion of required attestations, we now estimate a total annual burden of 2,595 applicant hours to complete the application. This resulted in a total increase in burden from 7,226 hours to 7,271 hours.

Annual Cost to Federal Government: $228,826

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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