State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations

Forms and Documents

Document Name	Status
CMS 319 - Supporting Statement Part A - Final.docx Supporting Statement A	2020-10-13

IC Document Collections

IC ID	Document Title	Status
43652	State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations at 42 CFR 431.800 - 431.865	Modified

ICR Details

OMB Control No: 0938-0147	ICR Reference No: 202010-0938-008
Status: Received in OIRA	Previous ICR Reference No: 201609-0938-019
Agency/Subagency: HHS/CMS	Agency Tracking No: CPI - 319
Title: State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/13/2020

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	646	0
Time Burden (Hours)	64,600	0
Cost Burden (Dollars)	0	0

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Abstract: The Medicaid Eligibility Quality Control (MEQC) program provides states and the District of Columbia (hereinafter, “states”) a unique opportunity to improve the quality and accuracy of their Medicaid and Children’s Health Insurance Program (CHIP) eligibility determinations. The MEQC program is intended to complement the Payment Error Rate Measurement (PERM) program by ensuring state operations make accurate and timely eligibility determinations so that Medicaid and CHIP services are appropriately provided to eligible individuals.

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Authorizing Statute(s): US Code: 42 USC 1396b Name of Law: Payment to States
  

Citations for New Statutory Requirements: None

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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:
	85 FR 27228	05/07/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 60169	09/24/2020
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations at 42 CFR 431.800 - 431.865

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ICR Summary of Burden

	Total Request	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	646	0	0	0	526	120
Annual Time Burden (Hours)	64,600	0	0	0	63,640	960
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: All 50 States and the District of Columbia will conduct the MEQC pilot during their off-cycle PERM years. At any given point in time, 34 States will be working on the front end or back end of their MEQC pilots. All states will be required to submit their MEQC case level reports and CAPs to CMS in a CMS specified format by August 1 following the end of the MEQC review period. The cumulative burden of conducting MEQC reviews and preparing case level reports and CAPs has been increased (from 1500 hours to 1900 hours, a total of 400 hours/state) from the estimate found in the preamble to the final regulation of July 5, 2017 as published in the Federal Register (82 FR 31158). The increase in burden is based on the actual time period available to states for conducting sampling, performing MEQC case reviews, and developing case level reports and CAPs. This period is substantially longer than the duration of each round of the previous eligibility pilots; and the required caseloads are commensurately larger.

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Annual Cost to Federal Government: $291,360

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? No

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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: 10/13/2020

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