Medicare Advantage Chronic Care Improvement Program (CCIP) Attestations (CMS-10209)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10209 CCIP Attestation	Form	Modified	Repair queued
Form CMS-10209 Attestations	Form	Modified	Repair queued
CMS-10209- Supporting Statement A.docx	Supporting Statement A	Uploaded 2021-06-17	Repair queued
Crosswalk_OMB 0938-1023_508.pdf	Supplementary Document	Uploaded 2021-06-15	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
229160	Attestations	Form	Modified	CCIP Attestation
229160	Attestations	Form	Modified

ICR Details

OMB Control No: 0938-1023	ICR Reference No: 202106-0938-007
Status: Historical Active	Previous ICR Reference No: 201804-0938-016
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Medicare Advantage Chronic Care Improvement Program (CCIP) Attestations (CMS-10209)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/20/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/17/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2025	36 Months From Approved	05/31/2022
Responses	645	0	750
Time Burden (Hours)	161	0	188
Cost Burden (Dollars)	0	0	0

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Abstract: Section 1852(e) of the Social Security Act requires that MA organizations (MAOs) have an ongoing quality improvement program. CMS regulations at 42 CFR §422.152 outline the quality improvement program (QI Program) requirements for MA plans, which includes the development and implementation of both a Quality Improvement Project (QIP) and a Chronic Care Improvement Program (CCIP). The 2014 approved packaged reflected a process that required plans to report QIP and CCIP projects’ progress reports annually. This reinstatement package outlines the burden for the attestation process that reduces burden by requiring plans to attest annually that they have an ongoing CCIP that meets the requirements outlined at 42 CFR §422.152, rather than report annual progress reports. MA plans will only have to attest to having a CCIP once the proposed rule (CMS-4182-F; RIN 0938-AT08) that removes the QIP is final.

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Authorizing Statute(s): Statute at Large: 18 Stat. 1852
  

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:
	86 FR 18534	04/09/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 32268	06/17/2021
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Attestations	CMS-10209	CCIP Attestation

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ICR Summary of Burden

table that charts list 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	645	750	0	-105	0	0
Annual Time Burden (Hours)	161	188	0	-27	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Burden has decreased due to the removal of the QIP attestation requirement and the collection now focusing on the single CCIP attestation requirement. Burden has also decreased due to a decrease in MA contracts participating from 750 to 645.

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Annual Cost to Federal Government: $18,160

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]? Yes

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: 06/17/2021

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