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View ICR - OIRA Conclusion

OMB Control No: 0938-1386	ICR Reference No: 202507-0938-022
Status: Active	Previous ICR Reference No: 202404-0938-023
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: 12/23/2025
	Date Received in OIRA: 07/28/2025
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2028	36 Months From Approved	12/31/2025
Responses	10,468	0	24,716
Time Burden (Hours)	1,745	0	4,120
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	10,468	24,716	-14,248
Annual Time Burden (Hours)	1,745	4,120	-2,375
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: Burden decreased in this collection is due to an error made in the data used for the previous package that included adverse, partially favorable, and fully favorable appeal decisions. The data should have only included adverse and partially favorable decisions; thus, the appeal number was higher leading to a higher burden erroneously. The overall number of applicable integrated plans and enrollees increased. In 2023, there were 112 applicable integrated plans with 810,377 enrollees. In 2025, there are 129 applicable integrated plans with 1,163,067 enrollees. The total number of hours is now 1,745.

Annual Cost to Federal Government: $6,523

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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