[Medicaid] Children's Health Insurance Program Managed Care and Supporting Regulations (CMS-10554)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Response to Public Comments (CMS-2439-F version 2).docx	Supplementary Document	Uploaded 2024-06-24	Repair queued
CMS-10554 - Supporting Statement A (CMS-2439-F version 13 OMB).docx	Supporting Statement A	Uploaded 2024-06-24	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
216803	State Requirements and Burden		Modified
216798	Private Sector Requirements and Burden		Modified

ICR Details

OMB Control No: 0938-1282	ICR Reference No: 202405-0938-012
Status: Active	Previous ICR Reference No: 202203-0938-014
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: [Medicaid] Children's Health Insurance Program Managed Care and Supporting Regulations (CMS-10554)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/13/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/25/2024
Terms of Clearance: OMB is approving this information collection request for a period of three years during which time the agency will request approval to extend or revise the collection if the agency seeks to continue the information collection activity beyond the period approved under this action.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2028	36 Months From Approved	10/31/2025
Responses	2,739,490	0	2,735,906
Time Burden (Hours)	402,811	0	410,588
Cost Burden (Dollars)	0	0	0

---

Abstract: CHIP enrollees use the information collected and reported as a result of this regulation to make informed choices regarding health care, including how to access health care services and the grievance and appeal system. States use the information collected and reported as part of contracting processes with managed care entities, as well as its compliance oversight role. CMS uses the information collected and reported in an oversight role of State CHIP managed care programs and CHIP state agencies.

---

Authorizing Statute(s): PL: Pub.L. 111 - 148 6401 Name of Law: Patient Protection and Affordable Care Act
   PL: Pub.L. 111 - 3 403 Name of Law: Children’s Health Insurance Program Reauthorization Act
   PL: Pub.L. 111 - 5 5006 Name of Law: American Recovery and Reinvestment Act of 2009
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 3 403 Name of Law: Children’s Health Insurance Program Reauthorization Act
PL: Pub.L. 111 - 5 5006 Name of Law: American Recovery and Reinvestment Act of 2009
PL: Pub.L. 111 - 148 6401 Name of Law: Patient Protection and Affordable Care Act

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AU99	Final or interim final rulemaking	89 FR 41002	05/10/2024

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 28092	05/23/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 41002	05/10/2024
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Private Sector Requirements and Burden
State Requirements and Burden

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	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	2,739,490	2,735,906	0	3,584	0	0
Annual Time Burden (Hours)	402,811	410,588	0	-7,777	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This 2024 iteration, is associated with our May 10, 2024 (89 FR 41002) managed care final rule (CMS-2439-F, RIN 0938–AU99). Overall, the rule adds 37,501 hours. Outside of the rule, this collection of information request also corrects our active time estimate by minus 45,277 hours. When combined, the net change is plus 3,586 responses and minus 7,776 hours. Rounding sets estimates at +/- 2.

---

Annual Cost to Federal Government: $20,800,000

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)? Yes

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  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:

(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: 06/25/2024

---