Medicare Advantage Disclosure Requirements referenced in 42 CFR 422.111(d)(2)

ICR 200809-0938-004

OMB: 0938-1051

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2008-08-21
Supporting Statement A
2008-08-21
ICR Details
0938-1051 200809-0938-004
Historical Active
HHS/CMS
Medicare Advantage Disclosure Requirements referenced in 42 CFR 422.111(d)(2)
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 11/25/2008
Retrieve Notice of Action (NOA) 09/04/2008
This ICR is approved consistent with the understanding that the reporting requirements are not duplicated in 0938-0753. CMS agrees to adjust the burden estimates, supporting statements, and information collection materials in 0938-0753 accordingly. Because this collection appears to require adjustments on an annual basis, this collection is approved for 12 months.
  Inventory as of this Action Requested Previously Approved
11/30/2009 36 Months From Approved
670 0 0
8,040 0 0
0 0 0

This final rule implements provisions of the Social Security Act (the Act) establishing and regulating the Medicare Advantage (MA) program. The MA program was enacted in Title II of The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) on December 8, 2003. The MA program replaces the Medicare+Choice (M+C) program established under Part C of the title XVIII of the Act, while retaining most key features of the M+C program. The MA program attempts to broadly reform and expand the availability of private health plan options to Medicare beneficiaries.

PL: Pub.L. 108 - 117 201 Name of Law: The Medicare Prescription Drug, Improvement, and Modernization Act of 2003
  
None

0938-AN06 Final or interim final rulemaking 70 FR 4588 01/28/2005

  73 FR 21138 04/18/2008
73 FR 47953 08/15/2008
Yes

1
IC Title Form No. Form Name
Medicare Advantage Disclosure Requirements referenced in 42 CFR 422.111(d)(2): CMS-10260

  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 670 0 0 670 0 0
Annual Time Burden (Hours) 8,040 0 0 8,040 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
New collection requirements for 422.111(d)(2)-disclosure requirements for changes to a MA plan. Organizations will use a combined standardized document to notify enrollees of plan changes for the upcoming year.

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Bonnie Harkless 4107865666

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/04/2008


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