Medicare Advantage, Section 1876 Cost Plans, and Prescription Drug Program: Notification of Free Interpreter Services (CMS-10802)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-10802 - Supporting_Statement A (CMS-4205-P version 4).docx	Supporting Statement A	Uploaded 2024-04-05	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
266578	Notice of Availability		New
251079	Multi-Language Insert	Other-Multi-Language Insert (MLI)	Removed

ICR Details

OMB Control No: 0938-1421	ICR Reference No: 202404-0938-004
Status: Historical Inactive	Previous ICR Reference No: 202207-0938-018
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Medicare Advantage, Section 1876 Cost Plans, and Prescription Drug Program: Notification of Free Interpreter Services (CMS-10802)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 07/01/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/05/2024
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2025	36 Months From Approved	12/31/2025
Responses	20,800,000	0	20,800,000
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	312,000	0	312,000

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Abstract: CMS requires MA organizations and Part D sponsors to use the standardized document being submitted for OMB approval to satisfy disclosure requirements mandated by section 1851 (d)(3)(A) of the Act and 42 CFR 422.111 for MA organizations and section 1860D-1(c) of the Act and 42 CFR 423.128(a)(3) for Part D sponsors. We are proposing to reinstitute a requirement to use the MLI under §§ 422.2267(e)(31) and 423.2267(e)(33).

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Authorizing Statute(s): US Code: 42 USC 1851(d)(3)(A) and 1860D-1(c) Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AV24	Proposed rulemaking	88 FR 78476	11/15/2023

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 78476	11/15/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Multi-Language Insert
Notice of Availability

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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: The proposed rule would replace the MLI with the Notice of Availability. Overall, we project a combined labor and non-labor burden of 540 responses, 1,080 hours and $308,000.

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Annual Cost to Federal Government: $8,018

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]? Yes

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: 04/05/2024

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