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View ICR - OIRA Conclusion

OMB Control No: 0938-1386	ICR Reference No: 202306-0938-003
Status: Historical Active	Previous ICR Reference No: 202004-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Applicable Integrated Plan Coverage Decision Letter (CMS-10716)
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: 11/13/2023
	Date Received in OIRA: 06/07/2023
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2025	36 Months From Approved	11/30/2023
Responses	24,716	0	693
Time Burden (Hours)	4,120	0	116
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	24,716	693	24,023
Annual Time Burden (Hours)	4,120	116	4,004
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: The burden increase for this collection was due to the increase in the number of applicable integrated plans and enrollees. In 2021, there were 95 applicable integrated plans with 210,000 enrollees. In 2023, there are 112 applicable integrated plans with 810,377 enrollees. This caused the number of hours to increase from 116 to 4120.

Annual Cost to Federal Government: $6,193

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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