(CMS-R-38) Medicare and Medicaid Programs: Conditions for Certification for Rural Health Clinics and Conditions for Coverage for FQHCs in 42 CFR 491

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS R-38 Supporting Statement 11-06-18.docx	Supporting Statement A	Uploaded 2018-11-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7968	491.9(b) Patient Care Policies - New RHCs		Modified
45407	491.9(b) Patient Care Policies - Existing RHCs		Modified
233902	491.11 - Program Evaluation - Existing FHQCs		New
233900	491.11 - Program Evaluation - New FQHCs		New
233897	491.9(b) - Patient Care Policies - Existing FQHCs		New
233896	491.9(b) Patient Care Policies - New FQHCs		New
190717	491.11 Program Evaluation - Existing RHCs		Modified
190716	491.11 - Program Evaluation - New RHCs		Modified

ICR Details

OMB Control No: 0938-0334	ICR Reference No: 201810-0938-010
Status: Historical Inactive	Previous ICR Reference No: 201701-0938-008
Agency/Subagency: HHS/CMS	Agency Tracking No: 20561
Title: (CMS-R-38) Medicare and Medicaid Programs: Conditions for Certification for Rural Health Clinics and Conditions for Coverage for FQHCs in 42 CFR 491
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 11/09/2018
	Date Received in OIRA: 11/07/2018
Terms of Clearance: In accordance with 5 CFR 1320, the revision of this information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	36 Months From Approved	06/30/2020
Responses	8,656	0	8,656
Time Burden (Hours)	37,216	0	37,216
Cost Burden (Dollars)	0	0	0

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Abstract: This information is needed to determine if rural health clinics and federally qualified health centers meet the requirements to participate in the Medicare Program.

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Authorizing Statute(s): US Code: 42 USC 1395 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT23	Proposed rulemaking	83 FR 47686	09/20/2018

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
491.9(b) Patient Care Policies - New FQHCs
491.9(b) - Patient Care Policies - Existing FQHCs
491.11 - Program Evaluation - New FQHCs
491.11 - Program Evaluation - Existing FHQCs
491.9(b) Patient Care Policies - New RHCs
491.9(b) Patient Care Policies - Existing RHCs
491.11 - Program Evaluation - New RHCs
491.11 Program Evaluation - Existing RHCs

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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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The number of affected RHCs was adjusted from 4,247 to 4,160, hourly wages were updated to reflect the latest (May 2017) data from BLS, staffing requirements and burdens have been adjusted to be what we hope is more realistic, and FQHC burden that was previously unaccounted for has been added. In addition, the reviewing requirements associated with §491.9 and §491.11 have been changed from annual requirements to biennial requirements. Although we have halved our reporting requirements, the adjustments to staffing requirements, and newly accounting for FQHCs in this package, results in an increase in burden from 37,216 hours to 69,270 hours.

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Annual Cost to Federal Government: $0

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]? 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: 11/07/2018

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