Medicaid and CHIP Program (MACPro) (CMS-10434)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10434 (#3) GenIC #3 - Screen Shots (Alternative Benefit Plans)	Form	New	Available
Form CMS-10434 (#2) CHIP Eligibility	Form	New	Available
Form CMS-10434 (#2) CHIP Admin	Form	New	Available
Form CMS-10434 (#1) MACPro Homepage	Form	New	Available
Form CMS-10434 (#1) Initial Application (SPA Administration)	Form	New	Available
Form CMS-10434 (#1) Initial Application	Form	New	Available
CMS-10434 - Supporting Statement A [rev 03-28-2016 by OSORA PRA].docx	Supporting Statement A	Uploaded 2016-03-30	Available
MACPro PRA Hours Used and Upcoming Packages 03-22-16.xlsx	Supplementary Document	Uploaded 2016-03-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
220810	GenIC #3 - Alternative Benefit Plans (ABPs)	Form	New	GenIC #3 - Screen Shots (Alternative Benefit Plans)
220809	GenIC #2 - CHIP State Plan Eligibility	Form	New	CHIP Eligibility
220809	GenIC #2 - CHIP State Plan Eligibility	Form	New	CHIP Admin
220809	GenIC #2 - CHIP State Plan Eligibility	Instruction	New
220807	GenIC #1 - Initial Application	Form	New	MACPro Homepage
220807	GenIC #1 - Initial Application	Form	New	Initial Application (SPA Administration)
220807	GenIC #1 - Initial Application	Form	New	Initial Application
220807	GenIC #1 - Initial Application	Instruction	New

ICR Details

OMB Control No: 0938-1188	ICR Reference No: 201603-0938-022
Status: Historical Active	Previous ICR Reference No: 201301-0938-004
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicaid and CHIP Program (MACPro) (CMS-10434)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/19/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/31/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2019	36 Months From Approved	08/31/2016
Responses	280	0	280
Time Burden (Hours)	2,772	0	2,772
Cost Burden (Dollars)	0	0	0

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Abstract: CMS is in the process of evaluating Medicaid systems currently operating, in order to build an enterprise architecture platform and data repository. Ideally, CMS would allow for a single point of entry to access various program and operational data applications. This effort will be implemented in phases over several years. Phase 1 will provide for a Medicaid and CHIP Program data system (MACPro) accessed through a web portal/portlet that will automate the input and retrieval of data from the states related to CHIP eligibility and Alternative Benchmark Plans (ABP). This system will also support an efficient workflow for the review and approval of the CHIP and ABP process. States will access this system and submit program information into structured data templates. CMS staff will review the templates for compliance with federal statute, regulation and policy, provide feedback to the states and track/monitor the review and approval process. Future project phasing will provide for the design, delivery and implementation of financial management programs and performance and quality metrics. CMS must meet a hard deadline for the implementation of the Affordable Care Act. This system will be operational in phases with the CHIP eligibility and benchmark plans portions/modules to be implemented in January 2013.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1103 Name of Law: Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1103 Name of Law: Patient Protection and Affordable Care Act

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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 69227	11/09/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 17167	03/28/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
GenIC #3 - Alternative Benefit Plans (ABPs)	CMS-10434 (#3)	GenIC #3 - Screen Shots (Alternative Benefit Plans)
GenIC #1 - Initial Application	CMS-10434 (#1), CMS-10434 (#1), CMS-10434 (#1)	Initial Application ,   Initial Application (SPA Administration) ,   MACPro Homepage
GenIC #2 - CHIP State Plan Eligibility	CMS-10434 (#2), CMS-10434 (#2)	CHIP Admin ,   CHIP Eligibility

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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	280	280	0	0	0	0
Annual Time Burden (Hours)	2,772	2,772	0	0	0	0
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: $17,800,000

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]? Yes

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: 03/31/2016

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