Medicaid and CHIP Program (MACPro)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10434 ABP	Form and Instruction	New	Available
Form CMS-10434 CHIP Eligibility	Form and Instruction	New	Available
Form CMS-10434 CHIP Administration	Form and Instruction	New	Available
Form CMS-10434 Medicaid Administration	Form and Instruction	New	Available
Form CMS-10434 Initial Application	Form and Instruction	New	Repair queued
Form CMS-10434 MACPro Homepage	Form	New	Available
Step 4 - Response to Comments_12_7.docx	Supplementary Document	Uploaded 2013-01-09	Available
ABP Webinar.pdf	Supplementary Document	Uploaded 2013-01-09	Available
CHIP Eligibility Transcript.pdf	Supplementary Document	Uploaded 2013-01-09	Available
CHIP Admin Webinar Transcript.pdf	Supplementary Document	Uploaded 2013-01-08	Available
Medicaid Administration Transcript.pdf	Supplementary Document	Uploaded 2013-01-08	Available
Initial Application Transcript.pdf	Supplementary Document	Uploaded 2013-01-08	Available
Homepage Transcript.pdf	Supplementary Document	Uploaded 2013-01-08	Available
Step 2 - CMS-10434 - Supporting Statement part A [rev 01-24-2013].docx	Supporting Statement A	Uploaded 2013-01-24	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
205312	Alternative Benefit Plan (ABP)	Instruction	New
205312	Alternative Benefit Plan (ABP)	Form and Instruction	New	ABP
205311	CHIP Administration & Eligibility	Form and Instruction	New	CHIP Eligibility
205311	CHIP Administration & Eligibility	Instruction	New
205311	CHIP Administration & Eligibility	Form and Instruction	New	CHIP Administration
205310	Medicaid Administration	Form and Instruction	New	Medicaid Administration
205310	Medicaid Administration	Instruction	New
205309	Initial Application	Form and Instruction	New	Initial Application
205309	Initial Application	Instruction	New
205308	MACPro Home Page	Form	New	MACPro Homepage

ICR Details

OMB Control No: 0938-1188	ICR Reference No: 201301-0938-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicaid and CHIP Program (MACPro)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/20/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/09/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2016	36 Months From Approved
Responses	280	0	0
Time Burden (Hours)	2,772	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CMS is in the process of evaluating Medicaid systems currently operating, in order to build an enterprise architecture platform and data repository. Ideally, CMS would allow for a single point of entry to access various program and operational data applications. This effort will be implemented in phases over several years. Phase 1 will provide for a Medicaid and CHIP Program data system (MACPro) accessed through a web portal/portlet that will automate the input and retrieval of data from the states related to CHIP eligibility and Alternative Benchmark Plans (ABP). This system will also support an efficient workflow for the review and approval of the CHIP and ABP process. States will access this system and submit program information into structured data templates. CMS staff will review the templates for compliance with federal statute, regulation and policy, provide feedback to the states and track/monitor the review and approval process. Future project phasing will provide for the design, delivery and implementation of financial management programs and performance and quality metrics. CMS must meet a hard deadline for the implementation of the Affordable Care Act. This system will be operational in phases with the CHIP eligibility and benchmark plans portions/modules to be implemented in January 2013.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1103 Name of Law: Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1103 Name of Law: Patient Protection and Affordable Care Act

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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 34046	06/08/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 75633	12/21/2012
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Alternative Benefit Plan (ABP)	CMS-10434	ABP
CHIP Administration & Eligibility	CMS-10434, CMS-10434	CHIP Administration ,   CHIP Eligibility
Initial Application	CMS-10434	Initial Application
MACPro Home Page	CMS-10434	MACPro Homepage
Medicaid Administration	CMS-10434	Medicaid Administration

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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	280	0	0	280	0	0
Annual Time Burden (Hours)	2,772	0	0	2,772	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection.

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Annual Cost to Federal Government: $0

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]? 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: 01/09/2013

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