Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-10062 - Supporting_Statement_A [rev 7-25-2013 by OSORA PRA].doc	Supporting Statement A	Uploaded 2013-07-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8640	Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments		Modified

ICR Details

OMB Control No: 0938-0838	ICR Reference No: 201307-0938-026
Status: Historical Inactive	Previous ICR Reference No: 200106-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: 20162
Title: Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 11/07/2013
	Date Received in OIRA: 07/30/2013
Terms of Clearance: Withdrawn per agency request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CMS requires hospital inpatient, hospital outpatient and physician diagnostic data from Medicare Advantage organizations to continue making payment under the risk adjustment methodology as required by the Social Security Act of 1967 as amended by the Balanced Budget Act of 1997; the Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000; and the Medicare Prescription Drug Benefit, Improvement and Modernization Act of 2003.

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Authorizing Statute(s): US Code: 42 USC 1853(a)(3)(B) Name of Law: Data Collection
   US Code: 42 USC 1856D-15(a)(1)(A) Name of Law: Risk Adjusted Part D Payment
   US Code: 42 USC 1853(a)(1)(A) Name of Law: Risk Adjusted Part C Payment
  

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 27400	05/10/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 42957	07/18/2013
Did the Agency receive public comments on this ICR? No

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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
Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: Our estimate of time and cost burden to submitters has increased due to increased enrollments in plans and beneficiaries.

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Annual Cost to Federal Government: $8,000,000

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: 07/30/2013

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