Medicare and Medicaid; Programs For All-Inclusive Care For The Elderly (PACE) Contained in 42 CFR Part 460 (CMS-R-244)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Summary of Changes_ CMS-R-244_3282017.docx	Supplementary Document	Uploaded 2017-05-09	Available
CMS-R-244 - Supporting Statement A - Passback_response_dvh6272017 CLEAN.docx	Supporting Statement A	Uploaded 2017-06-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8559	Requirements for PACE Entities		Modified
46621	State Requirements		Modified

ICR Details

OMB Control No: 0938-0790	ICR Reference No: 201702-0938-012
Status: Historical Active	Previous ICR Reference No: 201401-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Medicare and Medicaid; Programs For All-Inclusive Care For The Elderly (PACE) Contained in 42 CFR Part 460 (CMS-R-244)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/28/2017
	Date Received in OIRA: 02/24/2017
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	06/30/2017
Responses	165	0	99
Time Burden (Hours)	71,455	0	56,181
Cost Burden (Dollars)	0	0	0

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Abstract: 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.

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Authorizing Statute(s): PL: Pub.L. 106 - 554 903 Name of Law: Medicare, Medicaid and SCHIP Benefits Improvement Act of 2000
   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
  

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 81772	11/18/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 11037	02/17/2017
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Requirements for PACE Entities
State Requirements

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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	165	99	0	66	0	0
Annual Time Burden (Hours)	71,455	56,181	0	15,274	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: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Total annual burden, in aggregate, for this collection, is now estimated to be 71,455 hours. This represents an upward adjustment of +15,274 hours from the currently-approved estimate of 56,181 hours annually. This revised total estimate, in large part, reflects an increase in active POs. The currently-approved burden specific to the PO (48,006 hours of the 56,181 total hours) accounts for 74 active PACE programs. We have revised the burden estimates upward to include all currently-active PACE programs (about 120) plus an average of 10 new PACE programs resulting from initial applications submitted annually over the next 3 year approval cycle, for a total of 130 PACE plans. In addition, we have extracted the application burden from this collection (previously estimated to be 3,775 hours). However, the new, automated application process relies to a significant extent on attestations and more limited documentation uploads and only captures the burden associated with the required uploads. We therefore are recognizing the burden associated with the development of required documentation that is not uploaded as part of the application in this collection, which also contributes to the increased estimated annual burden. The burden associated with requirements related to 460.72(c)(5), regarding emergency preparedness and 460.202(a) and (b), regarding participant health outcomes data, is now captured as part of separate information collections, resulting in a decrease of -7,437 annual burden hours. The total annual burden attributed to the states’ role in this collection is now 10,115 hours, which represents an increase of 1,940 hours compared to the currently-approved collection (8,175 total annual hours). This estimate no longer includes applicable state burden (500 hours) related to the application process (460.12(a)(2)). However, while the estimated hour per response for the state’s tasks associated with 460.152(a)(3), 460.160(b) and 460.164(e) remains the same, the total estimated annual burden has increased because the estimate is based on a greater number of states (35 instead of 25).

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Annual Cost to Federal Government: $8,507

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: 02/24/2017

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