Transformed - Medicaid Statistical Information System (T-MSIS) (CMS-R-284)

ICR 202206-0938-014

OMB: 0938-0345

Federal Form Document

Forms and Documents
Supplementary Document
Supplementary Document
Supplementary Document
Supporting Statement B
Supporting Statement A
IC Document Collections
ICR Details
0938-0345 202206-0938-014
Received in OIRA 201905-0938-019
Transformed - Medicaid Statistical Information System (T-MSIS) (CMS-R-284)
Revision of a currently approved collection   No
Regular 06/10/2022
  Requested Previously Approved
36 Months From Approved 07/31/2022
648 660
6,480 6,600
0 0

State data are reported by the federally mandated electronic process, known as MSIS is currently collecting eligibility and claim data in 5 separate files. These data are the basis of actuarial forecasts for Medicaid service utilization and costs; of analysis and cost savings estimates required for legislative initiatives relating to Medicaid and for responding to requests for information from CMS components, the Department, Congress and other customers. The expanded version of MSIS is now referred to as TMSIS will incorporate 3 additional files (Provider, Managed Care Plans, and Third Party Liability).

PL: Pub.L. 105 - 32 4753 Name of Law: BBA
   PL: Pub.L. 108 - 173 103 Name of Law: MMA
   US Code: 42 USC 1935 Name of Law: Medicare Prescription Drugs
   PL: Pub.L. 114 - 148 6504 Name of Law: ACA
   US Code: 42 USC 1396b(r) Name of Law: MMIS
   US Code: 42 USC 1301 Name of Law: HIPAA Law
US Code: 45 USC 3434 Name of Law: HIPAA

Not associated with rulemaking

  87 FR 16739 03/24/2022
87 FR 35218 06/09/2022

IC Title Form No. Form Name
Transformed - Medicaid Statistical Information System (T-MSIS)

  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 648 660 0 0 -12 0
Annual Time Burden (Hours) 6,480 6,600 0 0 -120 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
The number of respondents decreased and the burden was adjusted accordingly.

Yes Part B of Supporting Statement
Mitch Bryman 410 786-5258 [email protected]


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.

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