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OMB Control No: 0938-0345	ICR Reference No: 202610-0938-005
Status: Received in OIRA	Previous ICR Reference No: 202606-0938-012
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: [Medicaid] Transformed - Medicaid Statistical Information System (T-MSIS) (CMS-R-284)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 10/20/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	02/28/2027
Responses	746	692
Time Burden (Hours)	37,390	29,290
Cost Burden (Dollars)	0	0

Authorizing Statute(s): PL: Pub.L. 108 - 173 103 Name of Law: MMA
   US Code: 42 USC 1935 Name of Law: Medicare Prescription Drugs
   PL: Pub.L. 114 - 148 6504 Name of Law: ACA
   US Code: 42 USC 1396b(r) Name of Law: MMIS
   US Code: 42 USC 1301 Name of Law: HIPAA Law
   PL: Pub.L. 119 - 21 71119 Name of Law: Working Families Tax Cut (WFTC) legislation
   PL: Pub.L. 105 - 32 4753 Name of Law: BBA
   PL: Pub.L. 119 - 21 71109 Name of Law: Working Families Tax Cut (WFTC) legislation

Citations for New Statutory Requirements: US Code: 45 USC 3434 Name of Law: HIPAA
PL: Pub.L. 119 - 21 71109 Name of Law: Working Families Tax Cut (WFTC) legislation

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	746	692	54
Annual Time Burden (Hours)	37,390	29,290	8,100
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This iteration proposes to add 8,100 hours of burden to comply with section 71109 (Alien Eligibility) of the WFTC legislation which limits FFP for full Medicaid and CHIP benefits, beginning October 1, 2026, to U.S. citizens and U.S. nationals, LPRs, Cuban/Haitian entrants, and COFA migrants. .

Annual Cost to Federal Government: $18,500,000

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]? Yes

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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