OMB files this comment in accordance with 5 CFR 1320.11( c ). This OMB action is not an
approval to conduct or sponsor an information collection under the Paperwork Reduction Act
of 1995. This action has no effect on any current approvals. If OMB has assigned this ICR a
new OMB Control Number, the OMB Control Number will not appear in the active inventory.
For future submissions of this information collection, reference the OMB Control Number
provided. OMB files this comment in accordance with 5 CFR 1320.11( c ). This OMB action is
not an approval to conduct or sponsor an information collection under the Paperwork Reduction Act
of 1995. This action has no effect on any current approvals. If OMB has assigned this ICR a
new OMB Control Number, the OMB Control Number will not appear in the active inventory.
For future submissions of this information collection, reference the OMB Control Number
provided. OMB is withholding approval at this time. Prior to publication of the final rule, the
agency should provide a summary of any comments related to the information collection and
their response, including any changes made to the ICR as a result of comments. In addition,
the agency must enter the correct burden estimates.
table that charts list comparision
Inventory as of this Action
Requested
Previously Approved
02/28/2017
36 Months From Approved
06/30/2017
99
0
99
56,181
0
56,181
0
0
0
PACE organizations must demonstrate their ability to provide quality community-based care for the frail elderly who meet their State's nursing home eligibility standards using capitated payments from Medicare and the state. The model of care includes as core services the provision of adult day health care and multidisciplinary team case management, through which access to and allocation of all health services is controlled. Physician, therapeutic, ancillary, and social support services are provided in the participant's residence or on-site at the adult day health center. PACE programs must provide all Medicare and Medicaid covered services including hospital, nursing home, home health, and other specialized services. Financing of this model is accomplished through prospective capitation of both Medicare and Medicaid payments.
US Code:
42 USC 1395eee
Name of Law: PAYMENTS TO, AND COVERAGE OF BENEFITS UNDER PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
PL:
Pub.L. 108 - 173 902
Name of Law: Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA)
US Code:
42 USC 1396U-4
Name of Law: PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
PL:
Pub.L. 105 - 33 4801
Name of Law: the Balanced Budget Act of 1997
PL:
Pub.L. 106 - 554 903
Name of Law: Medicare, Medicaid and SCHIP Benefits Improvement Act of 2000
PL: Pub.L. 106 - 554 903 Name of Law: Medicare, Medicaid and SCHIP Benefits Improvement Act of 2000
This PRA package reflects changes in CMS-R-244, corrections of errors, and proposed program changes laid out in a proposed rulemaking, CMS-4168-P.
⢠The number of PACE organizations has been updated from 74 to 119 reflecting 2016 current figures in the CMS HPMS system. Although the scope of this PRA package is for three years, we used the initial 2016 figures since they do not involve estimates.
⢠The number of states in which PACE organizations operate has been updated from 25 to 31 reflecting current 2016 current figures in the CMS HPMS system.
⢠Based on historical data for five years, the number of initial PACE applications has been updated to 25, a maximum for the five years, and the number of service area expansions has been updated to 10, a maximum for the five years. Consequently, the number of new entities annually has been updated to 35.
⢠Throughout the package, one-time costs have been annualized for three years. This is consistent with the scope of this PRA package. Consequently, annual figures may be added with annualized figures to produce a true estimate of cost in each of the next three years.
⢠Table 1, summarizing all impacts has been updated. Columns have been added to reflect whether the source of estimates is CMS-R-244 or NPRM CMS-4168-P. To improve readability, only one derived computational column, total cost, has been retained. The other columns, are raw data reflecting number of respondents, hourly wage, hours per respondent and a factor indicating annualization. When hours per respondent can be further broken down as products this information is contained in the narrative.
⢠The total cost column is consequently a combination of the previous four columns (product of three columns divided by the annualization factor). Consequently, errors in the previous table, when computations were not transparent, have been eliminated.
⢠This PRA package reflects about half a dozen line items corresponding to program changes in proposed CMS-4168-P. Furthermore, certain line items in the PRA have been eliminated or moved based on CMS-4168-P. For example, monitoring, 460.190, has been moved from the PRA section to the RIA section in CMS-4168-P and therefore has been eliminated from this PRA package; similarly, the requirement for a marketing tracking system, 460.82, is proposed to be eliminated by CMS-4168-P and is consequently eliminated from this PRA.
56,181 hours (currently approved)
22,197 hours (rule)
+8,958 (adjustments)
87,336 hours (new)
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:
(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;
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.
CMS-R-244 - Supporting Statement A [rev 08-16-2016 by OSORA PRA].docx
Medicare and Medicaid; Programs For All-Inclusive Care For The Elderly (PACE) Contained in 42 CFR 460.12-460.210