Justification for Nonsubstantive Change

Justification for Nonsubstantive Change

Quarterly Medicaid and CHIP Budget and Expenditure Reporting for the

Medical Assistance Program, Administration and CHIP

CMS-10529, OMB 0938-1265

The change removes Line 49 (Collections) on the CMS-21 expenditure series of forms and adds Line 4 (Adjustments – Decreasing Claims – Collections) to the Summary under CMS-21.

The change will not reduce or add burden since States are already reporting collections on the CMS-21 form. The revision simply permits States to report collections on a line that allows the collections to vary by Federal Medical Assistance Percentage (FMAP). This will ensure that Federal Financial Participation (FFP) is calculated correctly.

Absent this change, States cannot report collections associated with prior period at the proper FMAP. Reporting collections at the improper FMAP may lead to an inaccurate amount of FFP being paid by CMS to States or being returned from States to CMS.

To make the best use of available funds, the revised CMS-21 instrument will be developed upon OMB approval. The revised screen shot will be provided to OMB when ready.

The revised CMS-21 Summary has been added to ROCIS under the CMS-21 ICR and can be identified as “Nonsubstantive Change to CMS-21 Summary.” No other changes to the package have been made.