Performance Data Collection for SMP Program Outcome

Forms and Documents

Document Name	Status
Form 1 Performance Data Collection for SMP Program Outcome Revised Form	Modified
SMPOutcome_PRA_SectionA_Passback3.docx Supporting Statement A	2016-09-14

IC Document Collections

IC ID	Document Title	Status
190518	Performance Data Collection for SMP Program Outcome Revised Form	Modified

ICR Details

OMB Control No: 0985-0024	ICR Reference No: 201606-0985-001
Status: Historical Active	Previous ICR Reference No: 201211-0985-002
Agency/Subagency: HHS/ACL	Agency Tracking No:
Title: Performance Data Collection for SMP Program Outcome
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/27/2016
	Date Received in OIRA: 06/23/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2019	36 Months From Approved
Responses	54	0	0
Time Burden (Hours)	7,452	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This data collection is required by Congress for program monitoring and Government Performance Results Act (GPRA) purposes. This is the only data collection requested of the SMP Programs which is used by Congress and the media for reporting SMP activities. There are 54 programs in all 50 states, including the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands. It is imperative that data be collected to ensure that volunteers' contacts are giving Medicare beneficiaries the tools to prevent, detect and report health care fraud, error and abuse. The respondents are grantees and volunteers who meet with Medicare beneficiaries in group settings and in one-on-one sessions to educate them on the importance of being aware of fraud, error and abuse, and having the knowledge to protect the Medicare system.

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Authorizing Statute(s): PL: Pub.L. 104 - 191 1128C(a) Name of Law: HIPPA
   PL: Pub.L. 109 - 365 101 Name of Law: Older Americans Act
  

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:
	81 FR 11804	03/07/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 35361	06/02/2016
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Performance Data Collection for SMP Program Outcome Revised	1	SMP Outcome Form

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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	54	0	0	0	0	54
Annual Time Burden (Hours)	7,452	0	0	0	0	7,452
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: $29,516

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: 06/23/2016

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