Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516 (a)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10261 Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516 (a) - (CMS-10261)	Form	Modified	Available
CMS-10261. Response to 30_dayCommentsbyEntity 7_27_11.doc	Supplementary Document	Uploaded 2011-08-10	Available
CMS-10261.Revisions based on Public Comments.docx	Supplementary Document	Uploaded 2011-05-12	Available
TRK-Attachment III-changes.xls	Supplementary Document	Uploaded 2008-09-26	Available
TRK-Attachment II changes.09-22-08.doc	Supplementary Document	Uploaded 2008-09-26	Available
TRK-Attachment I.changes.9.23.08.doc	Supplementary Document	Uploaded 2008-09-26	Available
Attachment V_PartC_09.22.08.doc	Supplementary Document	Uploaded 2008-09-26	Available
Attachment IV.Part C _9.22.08.doc	Supplementary Document	Uploaded 2008-09-26	Available
Summary of Revisions-9-25-08.doc	Supplementary Document	Uploaded 2008-09-26	Available
CMS-10261 REVISED Supporting Statement Part A (12-5-11) (CLEAN).docx	Supporting Statement A	Uploaded 2011-12-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
186859	Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516 (a) - (CMS-10261)	Form	Modified

ICR Details

OMB Control No: 0938-1054	ICR Reference No: 201105-0938-008
Status: Historical Active	Previous ICR Reference No: 200810-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516 (a)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/20/2011
	Date Received in OIRA: 05/23/2011
Terms of Clearance: CMS continues to agree to include the technical specifications document in the ICR package and to make it available to the public during the public comment periods. ICR packages that do not contain this information and were not made available for public comment will be considered incomplete. CMS also understands that all burden-impacting changes--even technical changes like procedure and diagnosis codes that are revised annually--are subject to the PRA and require an opportunity for public comment before they are implemented. This includes changes that would require respondents to change their workflow processes or computer programs in order to accommodate those changes.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	36 Months From Approved	12/31/2011
Responses	8,445	0	12,709
Time Burden (Hours)	208,920	0	286,944
Cost Burden (Dollars)	0	0	0

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Abstract: The collection forces MA organizations to develop, compile, evaluate, and report to CMS, to its enrollees, and to the general public, as required by CMS' regulatory authority, which establishes reporting requirements (to ensure effective monitoring) for Part C Medicare Advantage.

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Authorizing Statute(s): PL: Pub.L. 110 - 275 164 Name of Law: MIPPA
  

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
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 79000	12/17/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 19775	04/08/2011
Did the Agency receive public comments on this ICR? Yes

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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
Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516 (a) - (CMS-10261)	CMS-10261, CMS-10261, CMS-10261	Attachment I - Part C Reporting Overview ,   Attachment III - Medicare Advantage Medical Utilization and Expenditure Experience ,   Medicare Part C Reporting Requirements

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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	8,445	12,709	0	-4,264	0	0
Annual Time Burden (Hours)	208,920	286,944	0	-78,024	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There is a decrease in cost and hour burden. One measure was added and another was enhanced, but these costs are more than offset by the suspension of two measures and the decrease in reporting frequency of some measures.

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Annual Cost to Federal Government: $300,000

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 05/23/2011

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