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View ICR - OIRA Conclusion

OMB Control No: 0938-0829	ICR Reference No: 202409-0938-016
Status: Active	Previous ICR Reference No: 202308-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Notice of Denial of Medical Coverage (or Payment) (NDMCP) (CMS-10003)
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: 11/13/2024
	Date Received in OIRA: 09/19/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2027	36 Months From Approved	12/31/2024
Responses	18,232,560	0	16,191,812
Time Burden (Hours)	3,037,544	0	2,697,556
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	18,232,560	16,191,812	2,040,748
Annual Time Burden (Hours)	3,037,544	2,697,556	339,988
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 annual hourly burden associated with this collection is estimated to be 3,037,544 hours. The annual hourly burden in the previous submission for this collection was 2,697,556 hours, resulting in an increase in the burden. The increase in burden is largely due to the increase in the number of Medicare health plan enrollees, which results in a greater number of organization determinations made by a Medicare health plan. CMS believes these adjusted burden estimates, drawn from the most current and reliable data available are appropriate for the purpose of developing the burden estimates for the IDN (CMS- 10003).

Annual Cost to Federal Government: $1,281

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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