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.
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