21st Century Cures Act Section 12002 IMD Study (CMS-10684)

Forms and Documents

Document Name	Status
Form CMS-10684 21st Century Cures Act Section 12002 IMD Study Survey Form	New
Response to Public Comment CMS-2018-0114-0001.docx Supplementary Document	2019-02-01
CMS-10684 - Supporting Statement B_revised 4-8-19 (002).docx Supporting Statement B	2019-04-10
CMS-10684 - Supporting Statement A (version 2).docx Supporting Statement A	2019-02-01

IC Document Collections

IC ID	Document Title	Status
234817	21st Century Cures Act Section 12002 IMD Study Survey Form	New

ICR Details

OMB Control No: 0938-1359	ICR Reference No: 201902-0938-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: 21st Century Cures Act Section 12002 IMD Study (CMS-10684)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/11/2019
	Date Received in OIRA: 02/05/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2020	36 Months From Approved
Responses	43	0	0
Time Burden (Hours)	86	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The 2016 CMS Medicaid managed care final rule established clear parameters for the coverage of services for people receiving treatment in Institutions for Mental Diseases (IMDs) in lieu of covered services in Medicaid Managed Care. Section 12002 of the 21st Century Cures Act requires the U.S. Department of Health and Human Services to conduct a study of the effects of these clarified parameters. The Act requires the study to examine 5 questions: 1) the extent to which states and territories provide capitated payments to Medicaid managed care plans for enrollees who receive services in IMDs; 2) the number of Medicaid enrollees who receive services in IMDs through such plans; 3) the range of and average number of months and the length of stay during such months that enrollees receive services in IMDs; 4) how such plans determine when to furnish services through an IMD in lieu of other benefits under their contract to address psychiatric or substance use disorder treatment; and 5) the extent to which the provision of services within such institutions has affected the capitated payments for plans. The State and Territory survey for which we are requesting clearance was developed and is needed to help answer the 5 mandated study questions. The data collected through the survey will be used by CMS develop a Report to Congress as required by the Act.

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Authorizing Statute(s): PL: Pub.L. 114 - 225 12002 Name of Law: 21st Century Cures Act
  

Citations for New Statutory Requirements: PL: Pub.L. 114 - 225 12002 Name of Law: 21st Century Cures Act

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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:
	83 FR 53474	10/23/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 734	01/31/2019
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
21st Century Cures Act Section 12002 IMD Study Survey	CMS-10684	21st Century Cures Act Section 12002 IMD Study Survey

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ICR Summary 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	43	0	43	0	0	0
Annual Time Burden (Hours)	86	0	86	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: Since this is a new collection, there are no changes.

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Annual Cost to Federal Government: $282,562

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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.     Yes

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: 02/05/2019

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