Medicaid Statistical Information System (MSIS) and the Transformed - Medicaid Statistical Information System (T-MSIS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
TMSIS PRA Supporting Statement - Part B - JDC bullet points 2012-12-14msf.docx	Supporting Statement B	Uploaded 2012-12-17	Available
Data Element Lists 2012-Dec and 2012-Feb as of 2012-11-12.xlsx	Supplementary Document	Uploaded 2012-12-17	Available
CMS-R-284_-_Supporting_Statement_part_A [rev 04-15-2013] CLEAN.doc	Supporting Statement A	Uploaded 2013-04-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7980	Medicaid Statistical Information System (MSIS)	Other-Data Dictionary	Modified
205266	Transformed - Medicaid Statistical Information System (T-MSIS)	Other-Data Dictionary	New

ICR Details

OMB Control No: 0938-0345	ICR Reference No: 201301-0938-002
Status: Historical Active	Previous ICR Reference No: 200911-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicaid Statistical Information System (MSIS) and the Transformed - Medicaid Statistical Information System (T-MSIS)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/23/2013
	Date Received in OIRA: 01/04/2013
Terms of Clearance: Prior to renewal of this ICR, CMS will provide OMB with an update on the needed frequency of data collection and whether collecting the information less frequently would still maintain a high level of data quality and achieve Program goals while reducing burden on State respondents.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2016	36 Months From Approved
Responses	816	0	0
Time Burden (Hours)	8,160	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: State data are reported by the federally mandated electronic process, known as MSIS is currently collecting eligibility and claim data in 5 separate files. These data are the basis of actuarial forecasts for Medicaid service utilization and costs; of analysis and cost savings estimates required for legislative initiatives relating to Medicaid and for responding to requests for information from CMS components, the Department, Congress and other customers. The expanded version of MSIS is now referred to as TMSIS will incorporate 3 additional files (Provider, Managed Care Plans, and Third Party Liability).

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Authorizing Statute(s): PL: Pub.L. 105 - 32 4753 Name of Law: BBA
   PL: Pub.L. 108 - 173 103 Name of Law: MMA
   US Code: 42 USC 1935 Name of Law: Medicare Prescription Drugs
   US Code: 42 USC 1396b(r) Name of Law: MMIS
   US Code: 42 USC 1301 Name of Law: HIPAA Law
   PL: Pub.L. 114 - 148 6504 Name of Law: ACA
  

Citations for New Statutory Requirements: US Code: 45 USC 3434 Name of Law: HIPAA

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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:
	77 FR 48987	08/15/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 71599	12/03/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Transformed - Medicaid Statistical Information System (T-MSIS)
Medicaid Statistical Information System (MSIS)

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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	816	0	0	612	0	204
Annual Time Burden (Hours)	8,160	0	0	6,120	0	2,040
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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $225,000

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]? Yes

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: 01/04/2013

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