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.
US Code:
42
USC 1395w-23 Name of Law: Risk Adjusted Part C Payment
US Code: 42
USC 1395w-23 Name of Law: Data Collection
US Code: 42
USC 1395w-23 Name of Law: Risk Adjusted Part D Payment
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