Application to Use Burden/Hours from Generic PRA Clearance:
Medicaid and CHIP State Plan, Waiver, and Program Submissions
(CMS-10398, OMB 0938-1148)
Information Collection #5: Medicaid Payment Suspensions
Center for Medicaid and CHIP Services (CMCS)
Centers for Medicare & Medicaid Services (CMS)
The Centers for Medicare & Medicaid Services (CMS) work in partnership with States to implement Medicaid and the Children’s Health Insurance Program (CHIP). Together these programs provide health coverage to millions of Americans. Medicaid and CHIP are based in Federal statute, associated regulations and policy guidance, and the approved State plan documents that serve as a contract between CMS and States about how Medicaid and CHIP will be operated in that State. CMS works collaboratively with States in the ongoing management of programs and policies, and CMS continues to develop implementing guidance and templates for States to use to elect new options available as a result of the Affordable Care Act or to comply with new statutory provisions. CMS also continues to work with States through other methods to further the goals of health reform, including program waivers and demonstrations, and other technical assistance initiatives.
CMS collects information regarding payment suspensions that States have imposed against providers during the relevant reporting period. Under section 6402(h)(2) of the Affordable Care Act, States may not receive Federal matching funds when they fail to suspend payment to providers for which there is a pending investigation of a credible allegation of fraud against such providers, unless the State determines there is good cause to not suspend payments. The Final Rule implementing section 6402(h)(2) of the Affordable Care Act requires States to annually report to CMS information regarding payment suspensions they have imposed against providers during the relevant reporting period. CMS collects this data from States via a portal on the Medicaid.gov website.
No deviations are requested.
The total approved burden ceiling of the generic ICR is 86,240 hours, and CMS previously requested to use 6,720 hours, leaving our burden ceiling at 79,520 hours. CMS estimates that each State will complete the collection of data and submission to CMS within 20 hours. There is a potential universe of 56 respondents, so the total burden deducted from the total for this request is 1,120 hours.
Wage Estimate
To derive average costs, we used data from the U.S. Bureau of Labor Statistics’ May 2016 National Occupational Employment and Wage Estimates for all salary estimates (http://www.bls.gov/oes/current/oes_nat.htm). In this regard, the following table presents the mean hourly wage, the cost of fringe benefits (calculated at 100 percent of salary), and the adjusted hourly wage.
Occupation Title |
Occupation Code |
Mean Hourly Wage ($/hr) |
Fringe Benefit ($/hr) |
Adjusted Hourly Wage ($/hr) |
Computer and Information Analyst |
15-1120 |
$44.36 |
$44.36 |
$88.72 |
As indicated, we are adjusting our employee hourly wage estimates by a factor of 100 percent. This is necessarily a rough adjustment, both because fringe benefits and overhead costs vary significantly from employer to employer, and because methods of estimating these costs vary widely from study to study. Nonetheless, there is no practical alternative and we believe that doubling the hourly wage to estimate total cost is a reasonably accurate estimation method.
In aggregate, we estimate 1,120 hours (56 responses x 20 hours) at a cost of $99,366.40 (1,120 hrs x $88.72/hr).
Attachments
The following attachment is provided for this information collection:
Attachment A – Payment Suspension Screen Shots
Not applicable. This is an extension (without change) of a currently approved GenIC.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | CMS |
| File Modified | 0000-00-00 |
| File Created | 2021-01-21 |