Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a) (CMS-10261)

Forms and Documents

Document Name	Status
Appendix B_CMS-10261_Responses to 30 day comments 10-30-15 (2).docx Supplementary Document	2015-11-12
CMS-10261 - Supporting Statement A Passback4 -- CLEAN.docx Supporting Statement A	2016-02-12
Appendix A Responses 60_Day_Comments_CMS_10261_Part_C_RR_103015.pdf Supplementary Document	2015-11-12

IC Document Collections

IC ID	Document Title	Status
186859	Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a) Instruction	Modified

ICR Details

OMB Control No: 0938-1054	ICR Reference No: 201511-0938-004
Status: Historical Active	Previous ICR Reference No: 201509-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a) (CMS-10261)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/24/2016
	Date Received in OIRA: 11/12/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	36 Months From Approved	04/30/2017
Responses	3,072	0	6,715
Time Burden (Hours)	182,023	0	169,558
Cost Burden (Dollars)	0	0	0

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Abstract: CMS' regulatory authority to establish reporting requirements for Part C Medicare Advantage (MA) organizations is described in 42CFR ?422.516 (a). It is noted that each MA organization must have an effective procedure to develop, compile, evaluate, and report to CMS, to its enrollees, and to the general public, at the times and in the manner that CMS requires, and while safeguarding the confidentiality of the doctor-patient relationship, statistics and other information with respect to the following: (1) The cost of its operations. (2) The patterns of utilization of its services. (3) The availability, accessibility, and acceptability of its services. (4) To the extent practical, developments in the health status of its enrollees. (5) Other matters that CMS may require. With both growth in the number of participating organizations and the types of plan "packages" available to Medicare beneficiaries, the need for more extensive, in depth, and effective monitoring has increased. Therefore, CMS is requesting a 3 year OMB approval of additional Part C data reporting.

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Authorizing Statute(s): PL: Pub.L. 110 - 275 164 Name of Law: MIPPA
  

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:
	80 FR 24934	05/01/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 56468	09/18/2015
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a)

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ICR Summary 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	3,072	6,715	0	0	-3,643	0
Annual Time Burden (Hours)	182,023	169,558	0	12,420	45	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: This 2015 iteration includes both burden adjustments and program changes (see Supporting Statement section 15 for details). The total increase in hours is estimated at 12,465 hr while the total cost increase is estimated at $4,334,290.

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Annual Cost to Federal Government: $300,000

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: 11/12/2015

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