Medicaid Managed Care Quality including Supporting Regulations (CMS-10553)

Forms and Documents

Document Name	Status
CMS-10553 - Supporting Statement A_(CMS-2439-P version 3).docx Supporting Statement A	2023-08-31

IC Document Collections

IC ID	Document Title	Status
261973	Private Sector	New
216793	State Governments	Modified

ICR Details

OMB Control No: 0938-1281	ICR Reference No: 202307-0938-001
Status: Received in OIRA	Previous ICR Reference No: 202208-0938-012
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: Medicaid Managed Care Quality including Supporting Regulations (CMS-10553)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/31/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2026
Responses	6,087	2,655
Time Burden (Hours)	1,490,403	33,523
Cost Burden (Dollars)	0	0

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Abstract: The May 6, 2016, final rule (RIN 0938-AS25, CMS-2390-F) contains new and revised quality and quality strategy requirements that apply to states that contract with MCOs, PIHPs, PAHPs and certain PCCM entities to deliver Medicaid services. The burden for elements previously captured in the CMS-10108 package (0938-0920), related to quality strategy and quality assessment and performance improvement (QAPI) programs have been moved into this PRA package, as the final rule has re-codified non-EQR portions of the quality regulations from Section 438 Subpart D into Subpart E. This PRA package now includes the Medicaid Quality Assessment and Performance Improvement Programs, State Review of Accreditation Status, Medicaid Managed Care Quality Rating System, and Quality Strategy (QS).

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Authorizing Statute(s): PL: Pub.L. 105 - 33 4507 Name of Law: BBA of 1997
  

Citations for New Statutory Requirements: PL: Pub.L. 105 - 33 4705 Name of Law: BBA of 1997

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AU99	Proposed rulemaking	88 FR 28092	05/03/2023

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 28092	05/03/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Private Sector
State Governments

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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	6,087	2,655	0	3,432	0	0
Annual Time Burden (Hours)	1,490,403	33,523	0	1,456,880	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This iteration is associated with the changes proposed in our May 3, 2023 (88 FR 28092) NPRM (CMS-2439-P; RIN 0938-AU99). The proposed rule would establish the MAC Quality Rating System as a one-stop-shop where beneficiaries could access information about Medicaid and CHIP eligibility and managed care; compare plans based on quality and other factors key to beneficiary decision making, such as the plan's drug formulary and provider network; and ultimately select a plan that meets their needs. States would be required to collect data using the framework of a mandatory QRS Measure Set and, based on data collected, calculate and issue an annual quality rating to each managed care plan. States would also build a website display that must: allow users to view tailored information, compare managed care plans, provide information on quality ratings and directs users to resources on how to enroll in a Medicaid or CHIP plan. Overall, this iteration increases our active burden estimates by an additional 3,432 responses, an additional 1,456,880 hours, and additional $108,394,633.

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Annual Cost to Federal Government: $63,753,329

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: 08/31/2023

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