Quarterly Medicaid and CHIP Budget and Expenditure Reporting for the Medical Assistance Program, Administration and CHIP (MBES/CBES Forms CMS-21 and -21B, -37, and -64) -- (CMS-10529)

ICR 202109-0938-005

OMB: 0938-1265

Federal Form Document

ICR Details
0938-1265 202109-0938-005
Received in OIRA 202107-0938-017
HHS/CMS CMCS
Quarterly Medicaid and CHIP Budget and Expenditure Reporting for the Medical Assistance Program, Administration and CHIP (MBES/CBES Forms CMS-21 and -21B, -37, and -64) -- (CMS-10529)
No material or nonsubstantive change to a currently approved collection   No
Regular 09/03/2021
  Requested Previously Approved
04/30/2024 04/30/2024
672 672
18,144 18,144
0 0

MBES/CBES is a financial reporting system that produces Budget and expenditures for Medical Assistance and Children's Health Insurance Program. All forms (CMS-21, -21B, -37, and -64) are to be filed on a quarterly basis and need to be certified by the States to the CMS.

PL: Pub.L. 116 - 16 7 Name of Law: Medicaid Services Investment and Accountability Act of 2019
   PL: Pub.L. 115 - 123 53102 Name of Law: Bipartisan Budget Act of 2018
   PL: Pub.L. 111 - 148 2301, 2501, and 2703 Name of Law: Affordable Care Act of 2009 (ACA)
   PL: Pub.L. 111 - 152 4701 and 5001 Name of Law: Affordable Care Act of 2009 (ACA)
  
None

0938-AT82 Final or interim final rulemaking 85 FR 87000 12/31/2020

  85 FR 37286 06/19/2020
85 FR 87000 12/31/2020
Yes

  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 672 672 0 0 0 0
Annual Time Burden (Hours) 18,144 18,144 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$3,492,571
No
    No
    No
Yes
No
No
Yes
Mitch Bryman 410 786-5258 [email protected]

  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.
09/03/2021


© 2021 OMB.report | Privacy Policy