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OMB Control No: 0938-0786	ICR Reference No: 202604-0938-021
Status: Active	Previous ICR Reference No: 202404-0938-013
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: [Medicaid] External Quality Review (EQR) of Medicaid and Children’s Health Insurance Program (CHIP) Managed Care, EQR Protocols, and Supporting Regulations (CMS-R-305)
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: 07/10/2026
	Date Received in OIRA: 06/09/2026
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2029	36 Months From Approved	10/31/2027
Responses	7,236	0	9,530
Time Burden (Hours)	887,087	0	482,802
Cost Burden (Dollars)	0	0	0

Abstract: The results of Medicare reviews, Medicare accreditation surveys, and Medicaid external quality reviews will be used by States in assessing the quality of care provided to Medicaid beneficiaries provided by managed care organizations and to provide information on the quality of the care provided to the general public upon request.

Authorizing Statute(s): Statute at Large: 19 Stat. 1932
   PL: Pub.L. 105 - 33 4705 Name of Law: BBA of 1997
   US Code: 42 USC 1396 Name of Law: External Independent Review of Managed Care Activities
   PL: Pub.L. 111 - 3 403 Name of Law: CHIPRA of 2009

Citations for New Statutory Requirements: PL: Pub.L. 111 - 3 403 Name of Law: CHIPRA of 2009

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 59835	12/22/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 21504	04/22/2026
Did the Agency receive public comments on this ICR? Yes

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	7,236	9,530	-2,294
Annual Time Burden (Hours)	887,087	482,802	404,285
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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This 2026 information collection request revises the active EQR protocols (which were last updated in 2023). The revisions include: (1) align existing protocols, appendices and worksheets with the May 13, 2024 managed care final rule (CMS-2439-F; RIN 0938-AU99), (2) add a new protocol related to assisting states with quality ratings for the MAC QRS, and (3) update burden estimates to reflect the most accurate, current, and applicable EQR activities. The rule will revise the EQR activities to remove the requirement for PCCM entities to conduct EQR, and to add two new optional activities: assisting states with the quality rating of MCOs, PIHPs, and PAHPs for the MAC QRS and to support states in conducting quality-related evaluations, as well as a few other technical changes to the way EQR results are reported, and the timing of EQR. The rule will also require states to maintain a 5-year archive of EQR reports on their websites and to require states notify CMS via email or other electronic correspondence when they have posted their EQR reports to their websites, and to share a link.

Annual Cost to Federal Government: $52,468,810

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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

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