Certification of Medicaid Eligibilty Quality Control (MEQC) Payment Error Rates and Supporting Regulations at 42 CFR.431.800 through 431.865

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-301 Certification of Medicaid Eligibilty Quality Control (MEQC) Payment Error Rates and Supporting Regulations at 42 CFR.431.800 through 431.865	Form and Instruction	Modified	Repair queued
CMS-301 Supporting Statement Part A.pdf	Supporting Statement A	Uploaded 2013-08-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7904	Certification of Medicaid Eligibilty Quality Control (MEQC) Payment Error Rates and Supporting Regulations at 42 CFR.431.800 through 431.865	Form and Instruction	Modified

ICR Details

OMB Control No: 0938-0246	ICR Reference No: 201308-0938-025
Status: Historical Active	Previous ICR Reference No: 200911-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No: 20376
Title: Certification of Medicaid Eligibilty Quality Control (MEQC) Payment Error Rates and Supporting Regulations at 42 CFR.431.800 through 431.865
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/26/2013
	Date Received in OIRA: 08/26/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2016	36 Months From Approved
Responses	51	0	0
Time Burden (Hours)	16,446	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: State agencies are required to submit the Payment Error Rate form to their respective CMS Regional Offices. Regional Office staff will review these forms for completeness and will forward these forms to the Central Office for compilation of error rate charts for projected quarterly withholdings and/or fiscal disallowances.

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Authorizing Statute(s): US Code: 42 USC 1396b Name of Law: Payment to States
  

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 32659	05/31/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 50057	08/16/2013
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
Certification of Medicaid Eligibilty Quality Control (MEQC) Payment Error Rates and Supporting Regulations at 42 CFR.431.800 through 431.865	CMS-301, CMS-301	CMS-301.MEQC Annual Report ,   Certfication of Eligibility/Error Rate

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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	51	0	0	0	0	51
Annual Time Burden (Hours)	16,446	0	0	0	0	16,446
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: $36,985

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: 08/26/2013

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