Non-Substantive Request justification

Non-Substantive Change Request to 0938-1384: Submissions of 1135 Waiver Request Automated Process

July 28, 2021

This is a non-substantive change request to the CMS 1135 Waiver/Flexibility Request and CMS 1135 Inquiry web pages from the ‘Submission of 1135 Waiver Request Automated Process’ that was approved as OMB number 0938-1384. As approved enhancements were implemented on the web pages, we found that some Organization Categories had inadvertently been removed prior to OMB approval. These minor corrections will not cause any changes in burden and will allow users to select the proper Organization Category for each type of request they may submit via the 1135 Waiver Request Automated Process. The changes are as follows:

CMS 1135 Waiver/Flexibility Request web page

• Correct an error on page 2, such that “State Medicaid Agency” is added under the ‘General Tab’ of the Organization Categories section.

• Correct an error on page 2, such that “Qualified Health Plan” is added under the ‘General Tab’ of the Organization Categories section.

• Correct an error on page 2, such that “Medicare Advantage/Part Plan D” is added under the ‘General Tab’ of the Organization Categories section.

• Correct an error on page 2, such that “Program of All-Inclusive Care for Elderly (PACE)” is added under the ‘Emergency Provider/Supplier Tab’ of the Organization Categories section.

• Correct an error on page 2, such that an extra instance of “Community Mental Health Center (CMHC)” is removed under the ‘Emergency Provider/Supplier Tab’ of the Organization Categories section.

• Correct an error on page 2, such that “Related” is now capitalized in “Ensuring Correct Processing of Home Health Disaster Related Claims…” under the ‘Waiver/Flexibility Request Type’ section of the Drop Down Options section.

• Correct an error on page 2, such that “Medicare” is now capitalized in “Extension for Medicare Geographic Classification Review Board (MGCRB) Applications…” under the ‘Waiver/Flexibility Request Type’ section of the Drop Down Options section.

• Correct an error on page 2, such that “pre-existing” is now spelled correctly in “Extension of pre-existing fee-for-service prior authorizations” under the ‘Waiver/Flexibility Request Type’ section of the Drop Down Options section.

• Correct an error on page 2, such that “Treatment” is now spelled correctly in “Psychiatric Residential Treatment Facility (PRTF): Survey…” under the ‘Waiver/Flexibility Request Type’ section of the Drop Down Options section.

• Correct an error on page 2, such that “Treatment” is now spelled correctly in “Psychiatric Residential Treatment Facility (PRTF): Payment” under the ‘Waiver/Flexibility Request Type’ section of the Drop Down Options section.

CMS 1135 Inquiry web page

• ORGANIZATION WORKFLOW: Correct an error on page 4, such that an extra instance of “Community Mental Health Center (CMHC)” is removed under the ‘Emergency Provider/Supplier Tab’ of the Organization Categories section.

• BENEFICIARY WORKFLOW: Correct an error on page 6, such that an extra instance of “Community Mental Health Center (CMHC)” is removed under the ‘Emergency Provider/Supplier Tab’ of the Organization Categories section.

These changes have no impact on the previously stated burden associated with this collection, which assumed that the errors listed would not exist.