Healthcare Fraud Prevention Partnership (HFPP): Data Sharing and Information Exchange (CMS-10501)

ICR 201812-0938-005

OMB: 0938-1251

Federal Form Document

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2018-12-07
Supplementary Document
2018-12-07
Supplementary Document
2018-12-07
Supporting Statement A
2018-12-07
Supplementary Document
2017-08-24
Supporting Statement B
2017-08-24
IC Document Collections
IC ID
Document
Title
Status
ICR Details
0938-1251 201812-0938-005
Active 201708-0938-019
HHS/CMS 21327
Healthcare Fraud Prevention Partnership (HFPP): Data Sharing and Information Exchange (CMS-10501)
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 12/10/2018
Retrieve Notice of Action (NOA) 12/10/2018
Previous terms continue: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument.
  Inventory as of this Action Requested Previously Approved
12/31/2021 12/31/2021 12/31/2021
55 0 55
176,800 0 176,800
0 0 0

Section 1128C(a)(2) of the Social Security Act (42 U.S.C. 1320a-7c(a)(2)) authorizes the Secretary and the Attorney General to consult with, and arrange for the sharing of data with representatives of health plans to establish a Fraud and Abuse Control Program as specified in Section 1128(C)(a)(1) of the Social Security Act. This is known as the Healthcare Fraud Prevention Partnership (HFPP). It was officially established by a Charter in fall 2012 and signed by HHS Secretary Sibelius and US Attorney General Holder. The HFPP is a joint initiative established by the Department of Health and Human Services and Department of Justice to detect and prevent the prevalence of healthcare fraud through data and information-sharing and applying analytic capabilities by the public and private sectors. The HFPP collaboration provides a unique opportunity to transition from traditional "pay and chase" approaches for fraud detection and recovery towards a data-driven model for identifying and predicting aberrant activity. A central goal of the HFPP is to identify the optimal way to coordinate nationwide sharing of health care claims information, including aggregating claims and payment information from large public healthcare programs and private insurance payers. In addition to sharing data and information, the HFPP is focused on advancing analytics, training, outreach, education to support anti-fraud efforts and achieving its objectives, primarily through goal-oriented, well-designed fraud studies. The HFPP's organizational structure is made up of an Executive Board, the Data Analysis and Review Committee, and the Information Sharing Committee. The HFPP will also include a Trusted Third Party that CMS will engage to provide the technical and operational platform to support the partnerships' data sharing, collaboration and study outreach activities. Enabling data sharing and providing analytical computing capabilities of the TTP is central to the success of the HFPP.

PL: Pub.L. 104 - 191 201 Name of Law: Fraud and abuse control program
   US Code: 42 USC 1320a-7c Name of Law: Fraud and abuse control program
  
PL: Pub.L. 104 - 191 201 Name of Law: Fraud and abuse control program
US Code: 42 USC 1320a-7c Name of Law: Fraud and abuse control program

Not associated with rulemaking

  82 FR 6559 01/19/2017
82 FR 16844 04/06/2017
Yes

0

  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 55 55 0 0 0 0
Annual Time Burden (Hours) 176,800 176,800 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The HFPP TTP is implementing a shift in the way studies are conducted for the purpose of detecting and deterring fraud, waste, and abuse among its partners. Moving to a framework with frequently updated data, including PHI and PII, the TTP will enable the HFPP to proactively identify vulnerabilities across participating entities in real time, significantly increasing the value of the HFPP to its partners. The TTP has developed a new process and expanded the set of data elements for submission by partners using a Cloud environment and resources that allows it to analyze data that is stored in many formats in the same file. It also allows for the partners to choose how to provide the data taking advantage of files, formats, and processes that the partners’ IT departments are using, either with the Special Investigations Unit (SIU), other internal components, or with third parties. As a result of this new streamlined process which incorporates procedures aimed at reducing the time and effort involved in retrieving claims data, the annual burden hours per partner has decreased from 1200 to 160 while allowing for the number of respondents to be increased from 15 to 20. The centers anticipate this to be an ongoing collection and request OMB approval for an additional three years.

$6,614,695
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Jamaa Hill 301 492-4190

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/10/2018


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