State Medicaid Fraud Control Units Annual Report and Recertification Application

Forms and Documents

Document Name	Status
0990-0162.doc Supporting Statement A	2007-08-08

IC Document Collections

IC ID	Document Title	Status
181665	Certification/Recertification Application	New
10317	State Medicaid Fraud Control Units Annual Report and Recertification Application	Modified

ICR Details

OMB Control No: 0990-0162	ICR Reference No: 200708-0990-001
Status: Historical Active	Previous ICR Reference No: 200401-0990-001
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: State Medicaid Fraud Control Units Annual Report and Recertification Application
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/12/2007
	Date Received in OIRA: 08/15/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2010	36 Months From Approved
Responses	98	0	0
Time Burden (Hours)	4,557	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information contained in the annual reports and recertification application requests is required for the yearly certification/recertification of the current 49 state Medicaid Fraud Control Units by the Office of Inspector General (OIG). The information collected is reviewed and evaluated by the OIG to insure that federal matching grant funds to the Units are only expended for allowable costs incurred by the Units. The OIG also uses the information to determine if a particular state unit or units' needs technical assistance.

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Authorizing Statute(s): PL: Pub.L. 95 - 142 17 Name of Law: null
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 18657	04/13/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 35710	06/29/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Certification/Recertification Application
State Medicaid Fraud Control Units Annual Report and Recertification Application

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	98	0	0	50	48	0
Annual Time Burden (Hours)	4,557	0	0	1,813	2,744	0
Annual Cost Burden (Dollars)	0	0	0	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: No

Burden Reduction Due to:

Short Statement: This is reinstatement with change

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Annual Cost to Federal Government: $5,292

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/09/2007

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