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.
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.
PL:
Pub.L. 107 - 300 2
Name of Law: The Improper Payments Information Act of 2002
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.
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.
Form CMS-10184 Payment Error Rate Measurement - State Medicaid and CHIP Eligibility
CMS 10184.Supporting Statement Part B(7-6-10).docx
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility