Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services

ICR 201401-0938-001

OMB: 0938-1127

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2013-12-24
ICR Details
0938-1127 201401-0938-001
Historical Active 201101-0938-003
HHS/CMS 21240
Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services
Extension without change of a currently approved collection   No
Regular
Approved without change 02/14/2014
Retrieve Notice of Action (NOA) 01/02/2014
  Inventory as of this Action Requested Previously Approved
02/28/2017 36 Months From Approved 04/30/2014
612 0 663
612 0 1,632
0 0 0

This provision is mandated by the Affordable Care Act, section 3309. To implement this provision, CMS needs data from the States, identifying full benefit dual-eligible individuals who are receiving home and community-based services. The States will provide these data as a new data value on their monthly MMA Phase Down report. These data are not available from any other source. CMS will use these new data to set the affected beneficiaries' Medicare Part D copayment to zero.

PL: Pub.L. 111 - 148 3309 Name of Law: Zero Copay for HCBS
  
None

Not associated with rulemaking

  78 FR 61848 10/04/2013
78 FR 77133 12/20/2013
No

  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 612 663 0 0 -51 0
Annual Time Burden (Hours) 612 1,632 0 0 -1,020 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Yes
No
No
Uncollected
Mitch Bryman 410 786-5258 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/31/2013


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