Fee-for-Service Improper Payment Rate Measurement in Medicaid and the Children’s Health Insurance Program (CMS-10166)

Forms and Documents

Document Name	Status
CMS - 10166 - Supporting Statement - Part A - Fee-for-Service _PERM 080224.docx Supporting Statement A	2024-08-28
CMS - 10166 - Supporting Statement - Part B - Fee-for-Service 5-16-24.docx Supporting Statement B	2024-08-23

IC Document Collections

IC ID	Document Title	Status
8834	Payment Error Rate Measurement in Medicaid and the State Children Health Insurance Program	Unchanged

ICR Details

OMB Control No: 0938-0974	ICR Reference No: 202408-0938-025
Status: Received in OIRA	Previous ICR Reference No: 202405-0938-017
Agency/Subagency: HHS/CMS	Agency Tracking No: OFM - IPPS
Title: Fee-for-Service Improper Payment Rate Measurement in Medicaid and the Children’s Health Insurance Program (CMS-10166)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/28/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	36	0
Time Burden (Hours)	59,400	0
Cost Burden (Dollars)	0	0

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Abstract: Improper Payments Information Act (IPIA) of 2002 requires CMS to produce national error rates for Medicaid and SCHIP. To comply with the IPIA, CMS needs the information to be collected from States and providers in order to sample and review adjudicated claims in a randomly selected number of States. Based on the reviews, State-specific error rates will be calculated which will be calculated which will serve as the basis for calculating national error rates for Medicaid and SCHIP.

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Authorizing Statute(s): US Code: 42 USC 1302a Name of Law: Rules and Regulations
   US Code: 42 USC 1396(a) Name of Law: State Plans for Medical Assistance
   US Code: 42 USC 1397gg Name of Law: Records, Reports, Audits, and Evaluation
   US Code: 42 USC 1302(a)(27) Name of Law: Rules and Regulations
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AV34	Final or interim final rulemaking	89 FR 68986	08/28/2024

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Payment Error Rate Measurement in Medicaid and the State Children Health Insurance Program

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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	36	0	0	2	0	34
Annual Time Burden (Hours)	59,400	0	0	3,300	0	56,100
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 is a reinstatement of a previously approved collection with minor adjusted information in the federal contracting costs, as well as, state burden estimates to reflect current practices in meeting PERM requirements, consisting of increased labor cost estimates. Hour estimates for state participation has not changed. Includes additional burden estimate for inclusion of Puerto Rico of 3,300 hours. The total maximum annual burden hours have increased from 56,100 to 59,400 which equates to the 3,300 hours anticipated for Puerto Rico inclusion. The maximum cost has increased from $3,339,072 to $3,820,608 which equates to $481,536.

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Annual Cost to Federal Government: $46,000,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 08/28/2024

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