Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a) (CMS-10261)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-10261 - Supporting Statement_ICR_2017_2018_Part_C_RR_080816 [rev 09-16-2016 by OSORA PRA].docx	Supporting Statement A	Uploaded 2016-09-23	Available
60 Day Comments and responses.docx	Supplementary Document	Uploaded 2016-09-23	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
186859	Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a)	Instruction	Modified

ICR Details

OMB Control No: 0938-1054	ICR Reference No: 201609-0938-009
Status: Historical Inactive	Previous ICR Reference No: 201511-0938-004
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a) (CMS-10261)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 09/28/2016
	Date Received in OIRA: 09/27/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	36 Months From Approved	02/28/2019
Responses	3,072	0	3,072
Time Burden (Hours)	182,023	0	182,023
Cost Burden (Dollars)	0	0	0

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Abstract: CMS' regulatory authority to establish reporting requirements for Part C Medicare Advantage (MA) organizations is described in 42CFR ?422.516 (a). It is noted that each MA organization must have an effective procedure to develop, compile, evaluate, and report to CMS, to its enrollees, and to the general public, at the times and in the manner that CMS requires, and while safeguarding the confidentiality of the doctor-patient relationship, statistics and other information with respect to the following: (1) The cost of its operations. (2) The patterns of utilization of its services. (3) The availability, accessibility, and acceptability of its services. (4) To the extent practical, developments in the health status of its enrollees. (5) Other matters that CMS may require. With both growth in the number of participating organizations and the types of plan "packages" available to Medicare beneficiaries, the need for more extensive, in depth, and effective monitoring has increased. Therefore, CMS is requesting a 3 year OMB approval of additional Part C data reporting.

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Authorizing Statute(s): PL: Pub.L. 110 - 275 164 Name of Law: MIPPA
  

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 29268	05/11/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 62741	09/12/2016
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a)

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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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: We estimated the number of contracts reporting in 2016, based on the number of contracts reporting in CY 2014 (n=544). The currently approved figure estimates 562 contracts. Organization Determinations/Reconsiderations This ICR now lists just four new data elements to the reporting section: Organization Determinations and Reconsiderations. These new data elements are needed to obtain more information about case reopenings. Increasing the number of data elements from 31 to 35 increased the estimated annual reporting burden for ODR by 9,604 hours. Per contract, the hourly burden increase for ODR was from 137 hours to 155 hours. Payments to Providers Adding Payments to Providers as a new reporting section increased hours by 11,312. Per contract, this resulted in an average increase of 20.8 hours. Enrollment/Disenrollment For the Enrollment/Disenrollment reporting section, the decrease in hours was 9.1 percent based on the percentage decrease in data elements from 22 to 20. This translated into a decrease of hour’s burden from 768 hours to 698 annual hours (a change of -70 hr). Former data elements 1-M and 1-N need to be removed since they no longer apply. This would decrease the reporting burden slightly. The data elements were: Of the number reported in A, the number of enrollment transactions submitted using the SEP Election Period code "S" related to SPAP. Of the number reported in A, the number of enrollment transactions submitted using the SEP Election Period code “S” related to SPAP. Sponsor Oversight of Agents Sponsor Oversight of Agents is being suspended. This 2017 suspension is still planned and would have a significant impact by lowering the resource utilization. The average decrease in hours is 62 per contract.

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Annual Cost to Federal Government: $300,000

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: 09/27/2016

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