Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project (CMS-10209)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10209 CCIP Attestation	Form	New	Available
Form CMS-10209 QIP Screen Shots - Submission Screen Annual Update	Form	Removed	Repair queued
Form CMS-10209 QIP Screen Shots - Study Section Annual Update	Form	Removed	Available
Form CMS-10209 QIP Screen Shots - Do Study Act Sections Annual Update	Form	Removed	Available
Form CMS-10209 QIP Screen Shots - Do Section Annual Update	Form	Removed	Available
Form CMS-10209 QIP Screen Shots - Contract Selection Screen Annual Update	Form	Removed	Available
Form CMS-10209 QIP Screen Shots - Act Section Annual Update	Form	Removed	Available
Form CMS-10209 CCIP Screen Shots - Submission Selection Screen Annual Update	Form	Removed	Available
Form CMS-10209 CCIP Screen Shots - Study Section Annual Update	Form	Removed	Available
Form CMS-10209 CCIP Screen Shots -- Do Study Act Sections Annual Update	Form	Removed	Available
Form CMS-10209 CCIP Screen Shots -- Do Section Annual Update	Form	Removed	Repair queued
Form CMS-10209 CCIP Screen Shots - Contract Selection Screen Annual Update	Form	Removed	Available
Form CMS-10209 CCIP Screen Shots - Act Section Annual Update.jpg	Form	Removed	Available
CMS-10209 - Supporting Statement A [rev 11-28-2017 by OSORA PRA].docx	Supporting Statement A	Uploaded 2017-11-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
229160	CCIP Attestation	Form	New	CCIP Attestation
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	QIP Screen Shots - Submission Screen Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	QIP Screen Shots - Study Section Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	QIP Screen Shots - Do Study Act Sections Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	QIP Screen Shots - Do Section Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	QIP Screen Shots - Contract Selection Screen Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	QIP Screen Shots - Act Section Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	CCIP Screen Shots - Submission Selection Screen Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	CCIP Screen Shots - Study Section Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	CCIP Screen Shots -- Do Study Act Sections Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	CCIP Screen Shots -- Do Section Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	CCIP Screen Shots - Contract Selection Screen Annual Update
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Form	Removed	CCIP Screen Shots - Act Section Annual Update.jpg
179877	Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	Instruction	Removed

ICR Details

OMB Control No: 0938-1023	ICR Reference No: 201711-0938-009
Status: Historical Inactive	Previous ICR Reference No: 201404-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project (CMS-10209)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule	Conclusion Date: 01/08/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/29/2017
Terms of Clearance: Terms of the previous clearance remain in effect. 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
Expiration Date		36 Months From Approved	07/31/2017
Responses	0	0	1,904
Time Burden (Hours)	0	0	28,560
Cost Burden (Dollars)	0	0	0

---

Abstract: Section 1852(e) of the Social Security Act requires that MA organizations (MAOs) have an ongoing quality improvement program. CMS regulations at 42 CFR §422.152 outline the quality improvement program (QI Program) requirements for MA plans, which includes the development and implementation of both a Quality Improvement Project (QIP) and a Chronic Care Improvement Program (CCIP). The 2014 approved packaged reflected a process that required plans to report QIP and CCIP projects’ progress reports annually. This reinstatement package outlines the burden for the attestation process that reduces burden by requiring plans to attest annually that they have an ongoing CCIP that meets the requirements outlined at 42 CFR §422.152, rather than report annual progress reports. MA plans will only have to attest to having a CCIP once the proposed rule (CMS-4182-F; RIN 0938-AT08) that removes the QIP is final.

---

Authorizing Statute(s): Statute at Large: 18 Stat. 1852
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT08	Proposed rulemaking	82 FR 56336	11/28/2017

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 56336	11/28/2017
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
CCIP Attestation	CMS-10209	CCIP Attestation
Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project	CMS-10209, CMS-10209, CMS-10209, CMS-10209, CMS-10209, CMS-10209, CMS-10209, CMS-10209, CMS-10209, CMS-10209, CMS-10209, CMS-10209	CCIP Screen Shots - Act Section Annual Update.jpg ,   CCIP Screen Shots - Contract Selection Screen Annual Update ,   CCIP Screen Shots -- Do Section Annual Update ,   CCIP Screen Shots -- Do Study Act Sections Annual Update ,   CCIP Screen Shots - Study Section Annual Update ,   CCIP Screen Shots - Submission Selection Screen Annual Update ,   QIP Screen Shots - Act Section Annual Update ,   QIP Screen Shots - Contract Selection Screen Annual Update ,   QIP Screen Shots - Do Section Annual Update ,   QIP Screen Shots - Do Study Act Sections Annual Update ,   QIP Screen Shots - Study Section Annual Update ,   QIP Screen Shots - Submission Screen Annual Update

---

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: Cutting Redundancy

Short Statement: We are removing the reporting requirement and burden (-28,560 hours). Consistent with this action, we are also removing the associated forms. In place of the reporting requirement, we have transitioned to an annual attestation requirement. The attestation involves no reporting of information or data. Consequently, the attestation requirements and burden are not subject to OMB approval under the PRA. Our proposed rule (CMS-4182-P; RIN 0938-AT08) would remove the QIP attestation requirement such that MAOs will only be required to attest that they have an ongoing CCIP. This version of the attestation would be subject to the PRA and is added to this package. The net burden is 188 hours.

---

Annual Cost to Federal Government: $19,305

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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: 11/29/2017

---