CMS-10295 - Supporting Statement A rev 07-22-2016 by OSORA PRA 09-14-2016 OMB Passback (002)CAHPG edits -- CLEAN

Supporting Statement for Paperwork Reduction Act

Recovery Act - Reporting Requirements for States under TMA Provisions

CMS-10295, OMB 0938-1073

Background

The Excel spreadsheet outlines the information each State must provide to the appropriate Regional Office of the Centers for Medicare & Medicaid Services (CMS) each calendar quarter, in accordance with the reporting requirements of the American Recovery and Reinvestment Act of 2009 (Recovery Act, P.L. 111-5), signed by President Obama on February 17, 2009:

• 5004(d) Extension of Transitional Medical Assistance (TMA)

A. Justification

1. Need and Legal Basis

The Secretary of Health and Human Services is required to submit annual reports to Congress with information collected from States in accordance with section 5004(d) of the Recovery Act.

2. Information Users

All State Medicaid Agencies in 50 States will complete the reports. CMS will review the information to determine if each State has met all of the reporting requirements for section 5004(d) of the Recovery Act.

3. Improved Information Technology

The reporting forms are available in electronic format as Excel spreadsheets. We expect every submittal to be forwarded to our agency using the electronic format. The documents are completed in a user-friendly format via email.

4. Duplication of Similar Information

There is no duplication of similar information.

5. Small Businesses

This collection does not impact small businesses.

6. Less Frequent Collection

The Recovery Act requires that each State provide reports every calendar quarter with the information specified for collection in section 5004(d) of the Recovery Act.

7. Special Circumstances

There are no special circumstances that would require an information collection to be conducted in a manner that requires respondents to:

• Report information to the agency more often than quarterly;

• Prepare a written response to a collection of information in fewer than 30 days after receipt of it;

• Submit more than an original and two copies of any document;

• Retain records, other than health, medical, government contract, grant-in-aid, or tax records for more than three years;

• Collect data in connection with a statistical survey that is not designed to produce valid and reliable results that can be generalized to the universe of study,

• Use a statistical data classification that has not been reviewed and approved by OMB;

• Include a pledge of confidentiality that is not supported by authority established in statute or regulation that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or

• Submit proprietary trade secret, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information's confidentiality to the extent permitted by law.

8. Federal Register Notice/Outside Consultation

The 60-day Federal Register notice published on May 11, 2016 (81 FR 29268). No comments were received.

9. Payment/Gift To Respondent

There is no payment/gift to respondents.

10. Confidentiality

There is no personal identifying information collected in the document. All the information is available to the public.

11. Sensitive Questions

There are no sensitive questions associated with this collection. Specifically, the collection does not solicit questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private.

12. Burden Estimate (Total Hours & Wages)

12.1 Wage Estimates

The following costs are based on the U.S. Bureau of Labor Statistics’ May 2015 National Occupational Employment and Wage Estimates for all salary estimates (http://www.bls.gov/oes/current/oes_nat.htm).

Occupation Title	Occupation Code	Mean Hourly Wage ($/hr)	Fringe Benefit ($/hr)	Adjusted Hourly Wage ($/hr)
Other Healthcare Practitioners and Technical Occupations (hereinafter, “technical staff”	29-9000	29.72	29.72	59.44

We are adjusting our employee hourly wage estimates by a factor of 100 percent. This is necessarily a rough adjustment, both because fringe benefits and overhead costs vary significantly from employer to employer, and because methods of estimating these costs vary widely from study to study. Nonetheless, there is no practical alternative and we believe that doubling the hourly wage to estimate total cost is a reasonably accurate estimation method.

12.2 Burden Estimates

The Excel spreadsheet will be completed for section 5004. We estimate that it will take no longer than 2 hours at $59.44/hr for State technical staff to complete and submit the spreadsheet to CMS for each of the four quarters in each Federal fiscal year (FY). The required number of respondents is the 50 States. In subsequent years, four quarterly reports will be required for section 5004, until the authority under the Recovery Act sunsets. Until that time, the total annual burden is 400 hours.

The total annual cost is estimated to be $23,776.

13. Capital Costs (Maintenance of Capital Costs)

There are no capital costs.

14. Cost to Federal Government

To derive average costs, we used data from OPM’s 2016 base salary for the Baltimore/Washington, D.C. region at the GS-13, step 5 level (www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/DCB_h.pdf). In this regard, the following table presents the mean hourly wage, the cost of fringe benefits (calculated at 100 percent of salary), and the adjusted hourly wage.

Grade (Step)	Hourly Wage ($/hr)	Fringe Benefit ($/hr)	Adjusted Hourly Wage ($/hr)
GS-13 (step 5)	50.04	50.04	100.08

As indicated, we are adjusting our employee hourly wage estimates by a factor of 100 percent. This is necessarily a rough adjustment, both because fringe benefits and overhead costs vary significantly from employer to employer, and because methods of estimating these costs vary widely from study to study. Nonetheless, there is no practical alternative and we believe that doubling the hourly wage to estimate total cost is a reasonably accurate estimation met

The following annualized cost to the federal government is based on the estimated time required to compile and review data collected quarterly from each state and compile the results into an annual report to Congress. This includes an estimate of wages of key reviewers and support staff.

Annualized Cost to Federal Government

CMS Staff Enter States’ Quarterly Reports into a Database	(1/4) hour x $100.08/hr x 50 states x 4 quarters	$5,004
CMS Staff Review & Analyze Data	(2) hours x $100.08/hr x 50 states	$10,008
Total		$15,012

The estimated cost for the entry, review, and analysis of quarterly TMA enrollment data from each state is $15,012.

15. Program or Burden Changes

This 2016 iteration does not propose any program changes or burden adjustments.

16. Publication and Tabulation Dates

Summary reports are required to be submitted to Congress each year after States’ quarterly reports have been received and compiled.

17. Expiration Date

The expiration date is displayed on the spreadsheet.

18. Certification Statement

There are no exceptions to the certification statement.

B. Collection of Information Employing Statistical Methods

The use of statistical methods does not apply to this form.

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