Payment Error Rate Measurement - State Medicaid and CHIP Eligibility

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10184 CMS-10184.FINAL-PERM Eligibility Error Rate Forms	Form	Modified	Available
Form CMS-10184 CMS-10184.FINAL-PERM Eligibility Error Rate Forms	Form	Modified	Available
Form CMS-10184 CMS-10184.FINAL-PERM Eligibility Error Rate Forms	Form and Instruction	Modified	Available
Form CMS-10184 CMS-10184.FINAL-PERM Eligibility Error Rate Forms	Form	Modified	Available
Form CMS-10184 CMS-10184.FINAL-PERM Eligibility Error Rate Forms	Form	Modified	Available
Form CMS-10184 CMS-10184.FINAL-PERM Eligibility Error Rate Forms	Form	Modified	Available
Form CMS-10184 CMS-10184.FINAL-PERM Eligibility Error Rate Forms	Form	Modified	Available
Form CMS-10184.FINAL-PE CMS-10184.FINAL-PERM_Eligibility_Error_Rate_Forms	Form	New	Available
Form CMS-10184E Summary Findings	Form and Instruction	Modified	Repair queued
Form CMS-10184B Detailed Active Case Review Findings	Form and Instruction	Modified	Available
Form CMS-10184A Cases Selected for Review: Monthly Sample Selection List	Form and Instruction	Modified	Available
Form CMS-10184D Detailed Payment Review Findings	Form and Instruction	Modified	Available
CMS 10184.Supporting Statement Part B(7-6-10).docx	Supporting Statement B	Uploaded 2010-07-13	Available
CMS 10184.Supporting Statement Part A(7-6-10).docx	Supporting Statement A	Uploaded 2010-07-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
46149	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Form	Modified	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
46149	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Instruction	Modified
46148	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Form	Modified	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
46148	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Instruction	Modified
46147	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Form and Instruction	Modified	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
46147	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Instruction	Modified
46146	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Form	Modified	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
46146	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Instruction	Modified
46145	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Form	Modified	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
46145	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Instruction	Modified
46144	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Instruction	Modified
46144	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Form	Modified	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
46143	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Instruction	Modified
46143	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	Form	Modified	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
193769	Reinstatement of Prior Burden Estimates for CMS-10184E	Instruction	New
193769	Reinstatement of Prior Burden Estimates for CMS-10184E	Form	New	CMS-10184.FINAL-PERM_Eligibility_Error_Rate_Forms
190303	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (MEQC Substitution)	Form and Instruction	Modified	Summary Findings
190303	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (MEQC Substitution)	Form and Instruction	Modified	Detailed Active Case Review Findings
190303	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (MEQC Substitution)	Form and Instruction	Modified	Cases Selected for Review: Monthly Sample Selection List
190303	Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (MEQC Substitution)	Form and Instruction	Modified	Detailed Payment Review Findings

ICR Details

OMB Control No: 0938-1012	ICR Reference No: 201007-0938-002
Status: Historical Active	Previous ICR Reference No: 201002-0938-008
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Payment Error Rate Measurement - State Medicaid and CHIP Eligibility
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 07/15/2010
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/15/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/13/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2011	6 Months From Approved	04/30/2013
Responses	1,583	0	1,379
Time Burden (Hours)	963,164	0	942,764
Cost Burden (Dollars)	0	0	0

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Abstract: The Improper Payments Information Act (IPIA) of 2002 requires CMS to produce national error rates for Medicaid and SCHIP. To comply with the IPIA, CMS needs the information to be collected in order to provide some Federal overview of state eligibility determinations to ensure correctness and consistency among states and to use the State-specific error rates as the basis for calculating national eligibility error rates for Medicaid and SCHIP.

Emergency Justfication: SUBJECT: Request for Emergency Clearance of the Paperwork Reduction Act Packages for the Payment Error Rate Measurement Program. The Centers for Medicare and Medicaid Services (CMS) is requesting that an information collection request (ICR) for the Payment Error Rate Measurement (PERM) be processed under the emergency clearance process, as stated in 5 CFR 1320.13(a)(2)(iii). Approval of this request is essential in order to comply with the current PERM regulation in which States participating in the cycle are responsible for calculating their eligibility error rates and submitting them to CMS. The current OMB approved package does not include this requirement that is still necessary for the current PERM fiscal year cycle. Background To implement the requirements of IPIA, CMS developed the PERM program. Under PERM, reviews are conducted in three areas for both the Medicaid and CHIP programs: 1) Fee-for-Service, 2) Managed Care and 3) Program Eligibility. Under the eligibility component, States draw monthly samples of cases and verify eligibility for each case based on State and Federal policies. These reviews result in an eligibility error rate that is included in the national payment error rates for Medicaid and CHIP. States are measured in a 17-State, three year rotation and therefore is measured once every three years. The Children's Health Insurance Program Reauthorization Act (CHIPRA) was enacted February 4th, 2009. Section 601(b) of CHIPRA requires CMS to have a final rule in effect for all States within six months of the enactment of the law. CMS immediately submitted an emergency justification to make necessary changes to the PRA package for the PERM eligibility component to coincide with the new regulation that was required by law. The most notable changes to the package were: o Allowing for the Medicaid Eligibility Quality Control (MEQC) burden estimates under OMB control numbers 0938-0146 and 0938-0246 to be used to comply with some of the PERM requirements per Section 601(e) of CHIPRA. o Allowing for the PERM eligibility burden estimates under OMB control number 0938-1012 to be used to comply with some of the MEQC requirements per Section 601(e) of CHIPRA. o Removing the burden estimates under OMB control number 0938-1012 for form CMS-10184E for States to calculate and submit their respective eligibility error rates to CMS. Unfortunately CMS was not able to publish and have the regulation in effect in the six month time period. Based on some of the changes, which now become effective in FY 2010 or FY 2011, when specified, under the new PERM final rule, the current PRA package, especially for form CMS-10184E is in conflict with the current regulation that the FY 2009 States are operating under.

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Authorizing Statute(s): PL: Pub.L. 107 - 300 2 Name of Law: The Improper Payments Information Act of 2002
  

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	CMS-10184	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	CMS-10184	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	CMS-10184	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	CMS-10184	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	CMS-10184	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	CMS-10184	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility	CMS-10184	CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (MEQC Substitution)	CMS-10184D, CMS-10184A, CMS-10184B, CMS-10184E	Detailed Payment Review Findings ,   Cases Selected for Review: Monthly Sample Selection List ,   Detailed Active Case Review Findings ,   Summary Findings
Reinstatement of Prior Burden Estimates for CMS-10184E	CMS-10184.FINAL-PERM_Eligibility_Error_Rate_Forms	CMS-10184.FINAL-PERM_Eligibility_Error_Rate_Forms

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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	1,583	1,379	0	204	0	0
Annual Time Burden (Hours)	963,164	942,764	0	20,400	0	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: There is a PERM cycle of States that are still subject to the current final rule in which States are responsible for calculating their eligibility error rates and submitting them to CMS. Therefore we are reinstating the burden for the current cycle of States that are still administering PERM under the current regulation.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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]? No

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: 07/13/2010

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