Medicare Parts C and D Universal Audit Guide

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
PRA - COMMENTS NARRATIVE 7_12_13--REDUCED.pdf	Supplementary Document	Uploaded 2013-07-24	Available
Appendix P - Engagement Letter_Start Notice-REDUCED.pdf	Supplementary Document	Uploaded 2013-07-24	Available
PRA - Crosswalk - Auidt Process CLEAN 7_10_13--REDUCED.pdf	Supplementary Document	Uploaded 2013-07-24	Available
PRA - Crosswalk - Universal Audit Guide _07_02_13--REDUCED.pdf	Supplementary Document	Uploaded 2013-07-24	Available
PRA - Crosswalk - Engagement Letter CLEAN 7_9_13--REDUCED.pdf	Supplementary Document	Uploaded 2013-07-24	Available
PRA - Crosswalk - Protocol 2012- 2013 changes v2--REDUCED.PDF	Supplementary Document	Uploaded 2013-07-24	Available
CMS-10191 - Supporting_Statement Part A [rev 11-13-2013 by OSORA PRA].docx	Supporting Statement A	Uploaded 2013-11-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43683	Medicare Parts C and D Universal Audit Guide	Instruction	Modified

ICR Details

OMB Control No: 0938-1000	ICR Reference No: 201307-0938-024
Status: Historical Active	Previous ICR Reference No: 200910-0938-014
Agency/Subagency: HHS/CMS	Agency Tracking No: 20142
Title: Medicare Parts C and D Universal Audit Guide
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: 12/13/2013
	Date Received in OIRA: 07/30/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	36 Months From Approved
Responses	195	0	0
Time Burden (Hours)	23,595	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: 42 CFR 422.502 describes CMS' regulatory authority to evaluate, through inspection or other means, Medicare Advantage Part C organizations. These records include books, contracts, medical records, patient care documentation and other records that pertain to any aspect of services performed, reconciliation of benefit liabilities, and determination of amounts payable. 42 CFR 423.503 states that CMS must oversee a Part D plan sponsor's continued compliance with the requirements for a Part D plan sponsor. 423.514 states that the Part D plan sponsor must have an effective procedure to develop, compile, evaluate, and report to CMS, to its enrollees, and to the general public, at the times and in the manner that CMS requires, statistics regarding areas such as cost of operations, patterns of utilization availability, accessibility, and acceptability of services. CMS developed a strategy to address our oversight and audit responsibilities within the context of limited audit/oversight resources. We intend to combine all Part C and Part D guides into one universal guide as it will promote efficiency and effectiveness and reduce financial and time burdens for both CMS and Medicare-contracting entities.

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Authorizing Statute(s): Statute at Large: 18 Stat. 1860 Name of Statute: null
   Statute at Large: 18 Stat. 1857 Name of Statute: null
  

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:
	78 FR 4412	02/22/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 42957	07/18/2013
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
Medicare Parts C and D Universal Audit Guide	CMS-10191, CMS-10191, CMS-10191	Self Disclosure Report ,   CPE SELF-ASSESSMENT QUESTIONNAIRE ,   Key Contacts for Compliance Program Operations

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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	195	0	0	0	0	195
Annual Time Burden (Hours)	23,595	0	0	0	-585	24,180
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: Under Routine Audits, the total hour burden has been adjusted from 120 hr to 121 hr. Also, the average number of hours per parent organization has been adjusted from 124 to 121 hr. Consequently, the total burden has been adjusted from 24,180 to 23,595 hr. The added and revised instructions, templates, and forms have no impact on the burden estimates. Please see the Crosswalks for changes.

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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]? 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: 07/30/2013

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