Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204 (CMS-10391)

Forms and Documents

Document Name	Status
Justification for Nonsubstantive Change.doc Justification for No Material/Nonsubstantive Change	2016-04-14
CMS-10391 - Supporting Statement A [rev 04-14-2016 by OSORA PRA].doc Supporting Statement A	2016-04-14

IC Document Collections

IC ID	Document Title	Status
218857	Public Process to Engage Stakeholders (on-going burden) (sec. 447.204(a)(1) and (2))	Unchanged
218855	Beneficiary Feedback Mechanism (on-going burden) (sec. 447.203(b)(7))	Unchanged
218854	Access Monitoring Review Plan (on-going burden) (sec. 447.203(b)(1) - (5))	Unchanged
197692	Public Process to Engage Stakeholders (one-time burden) (sec. 447.204(a)(1) and (2))	Unchanged
197691	Corrective Action Plan (sec. 447.203(b)(8))	Unchanged
197690	Beneficiary Feedback Mechanism (one-time burden) (sec. 447.203(b)(7))	Unchanged
197689	Access Monitoring Procedures Following Rate Reduction SPA (sec. 447.203(b)(6)(ii))	Unchanged
197688	Access Monitoring Review Plan (one-time burden) (sec. 447.203(b)(1) - (5))	Unchanged

ICR Details

OMB Control No: 0938-1134	ICR Reference No: 201604-0938-008
Status: Historical Active	Previous ICR Reference No: 201511-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204 (CMS-10391)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/29/2016
	Date Received in OIRA: 04/15/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	02/28/2019	02/28/2019
Responses	212	0	212
Time Burden (Hours)	30,501	0	30,501
Cost Burden (Dollars)	0	0	0

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Abstract: CMS-2328-FC requires a transparent, data-driven process for states to document that Medicaid beneficiaries have access to services covered under the Medicaid State plan to the extent that services are available to the general population in a geographic area. To meet the requirements of the final rule, states must conduct access review monitoring plans that measure: the extent that enrollee needs are met, the availability of care and qualified providers, service utilization and payment rate comparisons. The reviews will be conducted every three years for: primary care, physician specialists, behavorial health, and pre and post natal obstetric services (including labor and delivery). As states reduce or restructure provider payment rates or receive significant numbers of complaints from providers and beneficiaires about access to care, additional services must be included in the review plan and monitored for at least 3 years. We are soliciting comments on the services required for ongoing access reviews and the timelines associated with review and monitoring activities. The final rule also requires states have mechanisms for obtaining beneficiary and provider feedback on access to care, such as hotlines, surveys, ombudsman or other equivalent mechanisms and institute corrective action procedures should access issues be discovered through the access review and monitoring processes. Finally, when considering reductions to Medicaid payment rates the final rule requires states to undertake a process that gathers input from stakesholds and relies upon the information analyzed through the data reveiws on the proposed reduction or restructuring of Medicaid service payment rates.

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Authorizing Statute(s): Statute at Large: 42 Stat. 1902 Name of Statute: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AQ54	Final or interim final rulemaking	80 FR 67567	11/02/2015

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 26342	05/06/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 67567	11/02/2015
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 8

IC Title	Form No.	Form Name
Access Monitoring Review Plan (on-going burden) (sec. 447.203(b)(1) - (5))
Beneficiary Feedback Mechanism (on-going burden) (sec. 447.203(b)(7))
Public Process to Engage Stakeholders (on-going burden) (sec. 447.204(a)(1) and (2))
Access Monitoring Review Plan (one-time burden) (sec. 447.203(b)(1) - (5))
Access Monitoring Procedures Following Rate Reduction SPA (sec. 447.203(b)(6)(ii))
Beneficiary Feedback Mechanism (one-time burden) (sec. 447.203(b)(7))
Corrective Action Plan (sec. 447.203(b)(8))
Public Process to Engage Stakeholders (one-time burden) (sec. 447.204(a)(1) and (2))

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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	212	212	0	0	0	0
Annual Time Burden (Hours)	30,501	30,501	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: Not applicable, this is a new collection.

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Annual Cost to Federal Government: $0

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: 04/15/2016

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