0938-1148.Justification of Non-sub Change (Burden Ceiling Increase)-1-30-24

To: Phillip Pollman

Office of Information and Regulatory Affairs (OIRA)

Office of Management and Budget (OMB)

From: William Parham

Division of Information Collections and Regulatory Impacts

Office of Strategic and Regulatory Affairs

Date: January 30, 2024

Subject: Non-Substantive Change Request – Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (OMB# 0938-1148; CMS-10398)

This memo requests approval of non-substantive changes to the approved information collection, Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (OMB# 0938-1148; CMS-10398)

Background

The Centers for Medicare & Medicaid work in partnership with States to implement Medicaid and the Children’s Health Insurance Program (CHIP). Together these programs provide health coverage to millions of Americans. Medicaid and CHIP are based in Federal statute, associated regulations and policy guidance, and the approved State plan documents that serve as a contract between CMS and States about how Medicaid and CHIP will be operated in that State. When modifications or enhancements to the program are prescribed by Congress through legislation, each State’s programs must be amended to comply.

State Medicaid and CHIP agencies are responsible for developing submissions to CMS, including State plan amendments and requests for waivers and program demonstrations. States use templates when they are available and submit the forms to CMS to review for consistency with statutory and regulatory requirements (or in the case of waivers and demonstrations whether the proposal is likely to promote the objectives of the Medicaid program). If the requirements are met, CMS approves the State’s submission giving the State the authority to implement the flexibilities. For a State to receive Medicaid Title XIX funding, there must be an approved Title XIX State plan.

The development of streamlined submission forms enhances the collaboration and partnership between States and CMS by documenting CMS policy for States to use as they are developing program changes. Streamlined forms improve efficiency of administration by creating a common and user-friendly understanding of the information needed by CMS to quickly process requests for State plan amendments, waivers, and demonstration, as well as ongoing reporting.

This umbrella information collection request was last approved under by OMB on April 26, 2021 and expires April 30, 2024.

Overview of Requested Changes

In this January 2024 iteration we propose to increase our currently approved burden ceiling (from 154,104 hr to 450,000 hr) since the ceiling has been reached by pending collection of information submissions (see GenIC #43, #45, and #48, below). The increase is needed since the current ceiling is preventing the submission of such pending collections of information as the ROCIS system will not allow the limit to be exceeded.

The pending submissions will, however, be submitted to OMB for approval after the proposed increase has been approved.

Otherwise, we are not proposing any burden or program changes to any of the currently approved GenICs that fall under this collection’s umbrella.

The following table provides our active time figures, the time for our pending submissions, and our total request. Overall, we request an increase of 295,896 hours (450,000 hr proposed ceiling – 154,104 hr current ceiling). Of the 295,896 increase, 236,452 hours are for the pending submissions while 59,444 hours would cover upcoming unanticipated collections.

Of the 154,104 hour active ceiling, 30,384 of those hours are unused (154,104 ceiling – 123,720 used) but will be added to the 59,444 figure for a total of 89,828 hours available for other upcoming collections.

In sum, 450,000 hours = 23,720 hours (active) + 236,452 hours (pending, known) + 89,828 hours (unknown).

Active Collections (as of 01/29/2024)
Collections Carried Over (see NOAs dated and 04/26/2021 and 12/20/2023)	79,962
GenIC #69 (New): Reporting Requirements for Additional Funding for Medicaid HCBS During the COVID-19 Emergency	1,344
GenIC #37 (Revised): Medicaid Managed Care Rate Development Guide	5
GenIC #71 (New): Reporting Requirements for State Planning Grants for Qualifying Community Based Mobile Crisis Intervention Services During the COVID–19 Emergency	640
GenIC #69 (Nonsubstantive Change): Reporting Requirements for Additional Funding for Medicaid HCBS During the COVID–19 Emergency	5
GenIC #72 (New): Expressions of Interest in the Infant Well-Child Visit Affinity Group	140
GenIC #72 (Nonsubstantive Change): Expressions of Interest in the Infant Well-Child Visit Affinity Group	5
GenIC #66 (New): Medicaid and CHIP COVID 19 Public Health Emergency Unwinding Reports	14,224
GenIC #73 (New): Supplemental Payment Reporting under the Consolidated Appropriations Act, 2021	3,240
#13 (Revision): Medicaid Accountability – Nursing Facility, Outpatient Hospital and Inpatient Hospital Upper Payment Limits	5
#24 (Revision): Medicaid Accountability – Upper Payment Limits for Clinics, Physician Services, ICF/IID, PRTFs, and IMDs	5
#74 (New): Coverage of Routine Patient Cost for Items & Services in Qualifying Clinical Trials	61
#75 (New): ARP 1135 State Plan Amendment	168
#17 (Revision): CHIP State Plan Eligibility	5
GenIC #37 (revision): Managed Care Rate Setting Guidance	5
GenIC #57 (Revision): Medicaid Section 1115 Substance Use Disorder (SUD) Demonstration: Monitoring Reports Documents and Templates	5
GenIC #64 (Revision) Medicaid Section 1115 Substance Use Disorder (SUD) Demonstrations: Federal Meta-Analysis Support	5
GenIC #74 (Revised): Coverage of Routine Patient Cost for Items & Services in Qualifying Clinical Trials	5
GenIC #76 (New): Expressions of Interest in the Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Affinity Group	140
GenIC # 59 (Revision) - Medicaid Section 1115 Severe Mental Illness and Children with Serious Emotional Disturbance Demonstrations	3,314
CHIPRA Connecting Kids to Coverage Outreach and Enrollment Grants (CMS-10398; GenIC #7)	10,102
GenIC #7 (Revision): Connecting Kids to Coverage Outreach and Enrollment	7,826
#79 (New): COVID-19 Risk Corridor Reconciliation Reporting Template	90
GenIC #37 (Revision): Managed Care Rate Setting Guidance	135
GenIC #59 (Revision): Medicaid Section 1115 Severe Mental Illness and Children with Serious Emotional Disturbance Demonstrations	1,708
GenIC #64 (Revision): Federal Meta-Analysis Support: Section 1115 Substance Use Disorder Demonstrations	405
[Medicaid] GenIC #34 (Revised): Model Application Template and Instructions for State Child Health Plan Under Title XXI of the Social Security Act, State Children's Health Insurance Program	160
GenIC #37 (Revision): Managed Care Rate Setting Guidance	11
Subtotal (Active)	123,720
Pending (Known) Collection of Information Submissions
GenIC #43 Certified Community Behavioral Health Clinic (CCBHC) Cost Report	3,390
GenIC #45 Certified Community Behavioral Health Clinic (CCBHC) 2024 State Proposal Demonstration Application	1,790
GenIC #48 Behavioral Health Clinic Quality Data Reporting	231,272
Subtotal (Pending Known)	236,452
Revised Burden Ceiling
Future Collections (59,444 added + 30,384 currently available)	89,828
Proposed Burden Ceiling (123,720 used + 236,452 pending + 89,828 anticipated)	450,000