Supplemental Appropriations Act of 1008 Mandated Report to Congress (CMS-10281)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10281 Supplemental Appropriations Act of 2008 Mandated Report to Congress (CMS-10281)	Form and Instruction	New	Available
CMS-10281 Emergency PRA Justification.DOC	Supplementary Document	Uploaded 2009-04-10	Available
CMS-10281 Emergency PRA Justification.DOC	Supplementary Document	Uploaded 2009-04-10	Available
CMS-10281 Supporting Statement for Supplemental Appropriations Act of 2008 Mandatory Report to Congress.DOC	Supporting Statement A	Uploaded 2009-04-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
188980	Supplemental Appropriations Act of 2008 Mandated Report to Congress (CMS-10281)	Form and Instruction	New

ICR Details

OMB Control No: 0938-1061	ICR Reference No: 200904-0938-015
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Supplemental Appropriations Act of 1008 Mandated Report to Congress (CMS-10281)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 05/12/2009
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/11/2009
	Date Received in OIRA: 04/29/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2009	6 Months From Approved
Responses	51	0	0
Time Burden (Hours)	3,060	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Centers for Medicare & Medicaid Services (CMS) awarded The Lewin Group (Lewin) the contract for CMS RTOP-09-001 Mandated Report to Congress. Under this contract, Lewin is to perform the work defined in Section 7001(c)(2) of the Supplemental Appropriations Act, 2008 (SAA, P.L. 110-252). This section of the SAA requires that the Secretary of Health and Human Services (HHS) enter into a contract with an independent organization to produce a report on four specific Medicaid regulatory publications issued by the Centers for Medicare & Medicaid Services. Lewin will interview representatives of all 50 states and the District of Columbia in order to collect the information required to prepare this report. Lewin expects to begin the data collection process through interviews and data requests to state Medicaid officials to identify the structure for administrative and fiscal oversight for the affected service areas and claims and to assist in the identification of which claims associated with the regulations are not processed through states' MMIS. Lewin will also obtain information from state staff responsible for preparation and certification of the CMS-64, other state agencies to whom administrative or financial responsibilities for affected services have been delegated, and other government entities with relevant administrative responsibilities.

Emergency Justfication: See attached supplemental document for the emergency justification.

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Authorizing Statute(s): PL: Pub.L. 110 - 252 7001 Name of Law: Independent Comprehensive Study and Repor
  

Citations for New Statutory Requirements: PL: Pub.L. 110 - 252 7001 Name of Law: Independent Comprehensive Study and Report

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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:
	74 FR 16399	04/10/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Supplemental Appropriations Act of 2008 Mandated Report to Congress (CMS-10281)	CMS-10281	Mandated Report to Congress Independent Study and Report

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ICR Summary of Burden

table that charts list 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	51	0	51	0	0	0
Annual Time Burden (Hours)	3,060	0	3,060	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: This is a new collection.

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Annual Cost to Federal Government: $2,282,632

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)? No

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: 04/29/2009

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