Emergency Justification

Justification for Emergency PRA Package for the

State Plan Preprint to Implement Sections 6082 of the Deficit Reduction Act (DRA) of 2005

Reason for Emergency Submission

CMS is requesting that the new information collection request (ICR) entitled, “Health Opportunity Accounts” be processed under the emergency clearance procedures. As stated in 5 CFR 1320.13(a)(2)(i), the agency cannot reasonably comply with the normal clearance procedures as a statutory deadline related to the final rule will be missed if the normal clearance procedures are followed.

Background

The DRA provides states with numerous flexibilities in operating their State Medicaid programs. For example, Section 6082 of the DRA (Health Opportunity Accounts allows up to 10 States to operate Medicaid demonstrations to test alternative systems for delivering their Medicaid benefits. Under these demonstrations, States would have the flexibility to delivery their Medicaid benefits to volunteer beneficiaries through a program that is comprised of an HOA and a High Deductible Health Plan (HDHP).

Only 10 demonstrations will be approved during the initial 5 years of the program, which is to begin on January 1, 2007.

Under the DRA, States can submit SPAs to CMS to effectuate this change to their Medicaid programs. CMS will provide a State Medicaid Directors letter providing guidance on this provision and the implementation of the DRA and the associated SPA template for use by states to modify their Medicaid State plans if they choose to implement this flexibility. Previously, Medicaid program alternatives could only be implemented through the Section 1115 waiver process. Under this process, the end result is the State burden will be reduced significantly.

The DRA outlines deadlines that must be met. This deadline is January 1, 2007. In an effort to meet this deadline, CMS is requesting an emergency clearance of the Paperwork Burden Reduction Act.

Propose Timeline

Requested and Proposed Timelines

Date Activity

12/01/2006 Submit emergency justification to OMB

12/05/2006 Receive approval to submit emergency package to OMB

12/08/2006 Publication in the Federal Register Document - Beginning of 10 day public comment period and OMB review

12/18/2006 End of public comment period

12/22/2006 Requested date of OMB approval

12/27/2006 Release of State Medicaid Director’s Letter and State Plan Preprint to effectuate revisions prior to DRA statutory deadline of January 1, 2007

2