Summary/Response to Public Comment

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Responses to Comments Received to

Federal Register Notice on the Extension to the form

CMS-21

CMS received a comment on the January 31, 2011, notice on the proposed extension to the form CMS-21 (OMB 0938-0731) published on December 10, 2010. This Notice can be located in the Federal Register citation (75 FR 76988). The forms CMS-21, Quarterly Children’s Health Insurance Program (CHIP) Statement of Expenditures for the Title XXI Program State Plan Expenditures, has been used since July 1998, by the Medicaid State Agencies to report their actual program benefit costs and administrative expenses, and statistical information to the Centers for Medicare & Medicaid Services (CMS) required for implementation of the CHIP program, Title XXI of the Social Security Act (the Act).

Comment on Supporting Statement for the forms CMS-21

One commenter would like to be informed about any future modifications to the CMS-21 form.

One commenter strongly supports the continued collection of data for the Centers for Medicare and Medicaid Services’ (CMS) Quarterly Children’s Health Insurance Program Statement of Expenditures for Title XXI, Form CMS-21.

CMS Response

CMS would like to thank the commenter to support CMS providing the public with Quarterly CHIP Expenditure data. Should there be any revisions to the CMS-21, CMS will notify the public through the formal notification process as published in the Federal Register that provides the public with the opportunity to comment.