Given the increased importance of the accuracy of our Medicare Advantage risk adjustment methodology, we amended ? 422.310 in August of 2008 to announce that CMS would collect data from MA organizations regarding each item and service provided to an MA plan enrollee. This would allow CMS to incorporate the Medicare Advantage utilization in the development of risk adjustment models for the Medicare Advantage program.
The number of respondents have been adjusted from 827 (currently approved) to 683 (revised).
Also, various attachments have been added to this package. For instance, there is now a DME companion guide as the system now processes DME claims. The burden for DME is built into the cost of effort for a plan per year that is calculated in section 12 of this Supporting Statement, listed as $1,728.50. DME claims for encounter data is a smaller portion of Part B claims and therefore the process to create the data in the same format is reduced.
The remaining attachments comprise the submitter application, and EDI agreement, for Medicare Advantage plans or third party submitters that wish to request to receive a Submitter Identification number from CMS. This submitter ID obtained from the application process allows either party to submit plan data to CMS. The application will be found on the CSSC Website under the "Enroll to Submit Encounter Data" under the each major category of the website. The additional documents are the individual sections of the actual application form that is to be completed by Medicare Advantage plans or third party submitters. Because the submitters must currently complete a paper form today in order to obtain their number, we do not see completion of the electronic version of the form to be an additional burden.
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.
CMS-10340 - Supporting Statement A [rev 10-7-2014 by OSORA PRA].docx
Collection of Encounter Data from Medicare Advantage Organizations