Medicare Advantage Application - Part C and 1876 Cost Plan Expansion Application regulations under 42 CFR 422 subpart K & 417.400

ICR 201111-0938-003

OMB: 0938-0935

Federal Form Document

ICR Details
0938-0935 201111-0938-003
Historical Active 201009-0938-017
HHS/CMS
Medicare Advantage Application - Part C and 1876 Cost Plan Expansion Application regulations under 42 CFR 422 subpart K & 417.400
Revision of a currently approved collection   No
Regular
Approved with change 01/09/2012
Retrieve Notice of Action (NOA) 11/07/2011
  Inventory as of this Action Requested Previously Approved
01/31/2015 36 Months From Approved 01/31/2012
378 0 870
13,296 0 15,696
0 0 0

In order to provide health benefits to Medicare beneficiaries under the Medicare Advantage Program and/or the 1876 Cost Plan, applicant must meet regulatory requirements to enter into a contract with CMS, or to continue to contract with CMS. The revised Part C application is created to capture the applicants' information.

PL: Pub.L. 108 - 173 1857 Name of Law: Medicare Advantage
   PL: Pub.L. 110 - 275 161 Name of Law: Provisions relating to Part C
   US Code: 42 USC 1395mm Name of Law: null
  
None

Not associated with rulemaking

  76 FR 62414 10/07/2011
76 FR 38655 07/01/2011
Yes

  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 378 870 0 -492 0 0
Annual Time Burden (Hours) 13,296 15,696 0 -2,400 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
Overall Decrease Burden of Hours: The decrease in the overall burden hours is due to the decrease in the expected number of respondents. The number of SNP-only request will decrease because CMS has made an internal decision to not have all MA contractors that are currently offering a SNP product to complete and submit a SNP proposal. Only the MA organizations currently offering a SNP that requires re-approval under the NCQA SNP Approval process would be required to submit the Model of Care written narrative and Model of Care Matrix Upload Document portion of the SNP Proposal. Increase Burden Hours per application: An additional 5 hours of burden was added to the Initial application. This increase stems from an internal assessment of the application materials. For CY2013, CMS added three (3) new templates to clarify information that is being requested and to reduce confusion amongst applicants and reviewers. CMS also added three (3) new attestations. These attestations stems from regulatory changes at 42 CFR 422 subpart K.

$948,400
No
No
No
No
No
Uncollected
William Parham 4107864669

  No

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.
11/07/2011


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