External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364 (CMS-R-305)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-R-305 - Supporting Statement A [rev 05-04-2017 by OSORA PRA].docx	Supporting Statement A	Uploaded 2017-05-04	Available
2016.10.13 Response to Public Comments.docx	Supplementary Document	Uploaded 2016-11-25	Available
CMS-R-305 - Supporting State B [rev 11-25-2016 by OSORA PRA]].docx	Supporting Statement B	Uploaded 2016-11-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8551	(State Gov't) External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364	Instruction	Modified
216824	(Private Sector) External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364	Instruction	Modified

ICR Details

OMB Control No: 0938-0786	ICR Reference No: 201611-0938-016
Status: Historical Active	Previous ICR Reference No: 201506-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364 (CMS-R-305)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/16/2017
	Date Received in OIRA: 11/25/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	36 Months From Approved	05/31/2018
Responses	4,828	0	76
Time Burden (Hours)	426,476	0	451,288
Cost Burden (Dollars)	0	0	0

---

Abstract: The results of Medicare reviews, Medicare accreditation surveys, and Medicaid external quality reviews will be used by States in assessing the quality of care provided to Medicaid beneficiaries provided by managed care organizations and to provide information on the quality of the care provided to the general public upon request.

---

Authorizing Statute(s): PL: Pub.L. 105 - 33 4705 Name of Law: BBA of 1997
   US Code: 42 USC 1396 Name of Law: External Independent Review of Managed Care Activities
   Statute at Large: 19 Stat. 1932 Name of Statute: null
   PL: Pub.L. 111 - 3 403 Name of Law: CHIPRA of 2009
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 3 403 Name of Law: CHIPRA of 2009

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AS25	Final or interim final rulemaking	81 FR 27498	05/06/2016

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 31098	06/01/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 27498	05/06/2016
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
(State Gov't) External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364
(Private Sector) External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364

---

ICR Summary of Burden

table that charts list 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	4,828	76	0	4,752	0	0
Annual Time Burden (Hours)	426,476	451,288	0	-24,812	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Regulations

Short Statement: There are no changes to the EQR protocols. The currently approved information collection request sets out only one ICR. This 2016 iteration corrects the currently approved information collection request by setting out two ICRS: one for states and another for the private sector. Adjustments have been made to account for: (1) changes to the regulations per CMS-2390-F (see table set out below), (2) mathematical errors and estimate revisions in regards to the number of respondents, the type of respondents, annual responses, and annual hour burden, and (3) updated BLS job titles and wages.

---

Annual Cost to Federal Government: $17,214,830

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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

---

Common Form ICR:  No

---

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: 11/25/2016

---