[Medicaid] Transformed - Medicaid Statistical Information System (T-MSIS) (CMS-R-284)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-R-284 - Supporting Statement A (CMS-2454-IFC version 8).docx	Supporting Statement A	Uploaded 2026-06-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
280953	Collection of Community Engagement Data (Section 71119 of the WFTC Legislation)		New
205266	Transformed - Medicaid Statistical Information System (T-MSIS)	Other-Data Dictionary	Modified

ICR Details

OMB Control No: 0938-0345	ICR Reference No: 202606-0938-012
Status: Received in OIRA	Previous ICR Reference No: 202409-0938-023
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: [Medicaid] Transformed - Medicaid Statistical Information System (T-MSIS) (CMS-R-284)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 08/01/2026
Date Submitted to OIRA: 06/15/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	6 Months From Approved	11/30/2027
Responses	692	648
Time Burden (Hours)	29,290	7,290
Cost Burden (Dollars)	0	0

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Abstract: State data are reported by the federally mandated electronic process, known as MSIS is currently collecting eligibility and claim data in 5 separate files. These data are the basis of actuarial forecasts for Medicaid service utilization and costs; of analysis and cost savings estimates required for legislative initiatives relating to Medicaid and for responding to requests for information from CMS components, the Department, Congress and other customers. The expanded version of MSIS is now referred to as TMSIS will incorporate 3 additional files (Provider, Managed Care Plans, and Third Party Liability).

Emergency Justfication: On July 4, 2025, President Trump signed Public Law (P.L.) 119-21, also known as the "Working Families Tax Cut" (WFTC) legislation. This legislation includes eligibility and financing reforms in Medicaid and Children's Health Insurance Program (CHIP) policies that impact T-MSIS data reporting. Section 71119 of the WFTC legislation amends section 1902 to include new community engagement requirements generally for people eligible to enroll or who are enrolled in the adult group as described in §435.119 or those who are eligible to enroll or are enrolled under certain 1115 demonstrations that provide minimum essential coverage (MEC). This collection of information request addresses the T-MSIS data reporting requirements related directly to performing oversight, program integrity, and administration of section 71119 of the WFTC legislation.

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Authorizing Statute(s): PL: Pub.L. 108 - 173 103 Name of Law: MMA
   US Code: 42 USC 1935 Name of Law: Medicare Prescription Drugs
   PL: Pub.L. 114 - 148 6504 Name of Law: ACA
   US Code: 42 USC 1396b(r) Name of Law: MMIS
   US Code: 42 USC 1301 Name of Law: HIPAA Law
   PL: Pub.L. 119 - 21 71119 Name of Law: Working Families Tax Cut (WFTC) legislation
   PL: Pub.L. 105 - 32 4753 Name of Law: BBA
  

Citations for New Statutory Requirements: US Code: 45 USC 3434 Name of Law: HIPAA
PL: Pub.L. 119 - 21 71119 Name of Law: Working Families Tax Cut (WFTC) legislation

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AV98	Final or interim final rulemaking	91 FR 33348	06/03/2026

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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: 2

table that charts list of burden

IC Title	Form No.	Form Name
Collection of Community Engagement Data (Section 71119 of the WFTC Legislation)
Transformed - Medicaid Statistical Information System (T-MSIS)

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ICR Summary of Burden

table that charts list 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	692	648	44	0	0	0
Annual Time Burden (Hours)	29,290	7,290	22,000	0	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: No

Burden Reduction Due to:

Short Statement: With regard to the provisions under our June 3, 2026 interim final rule with comment period (CMS-2454-IFC; RIN 0938-AV98) entitled, “Medicaid Program; Community Engagement Requirement for Certain Individuals,” CMS has created a new file segment on the T-MSIS eligibility (ELG) file to collect data related to community engagement activities for adult group and applicable 1115 demonstration beneficiaries. The new segment includes a new set of data elements that reflect community engagement data the State would collect as part of a beneficiary’s eligibility determination under section 1902(xx) of the Act. In addition to the new file segments, states are also required to add new valid values to the WAIVER-TYPE data element to identify beneficiaries participating in applicable 1115 demonstrations and the ELIGIBILITY-TERMINATION-REASON to identify disenrollment related to community engagement requirements. States are required to update their T-MSIS eligibility files to report these new data for adult group and applicable 1115 demonstration beneficiaries. The burden for this new collection is estimated based on the level of effort required for States to undertake T-MSIS reporting modifications. This comprises a one-time effort to design, build, and test system changes that will ingest enrollment data from the states’ Medicaid Enterprise Systems and update the T-MSIS file submission format to incorporate the new community engagement data. States will need between 250 – 500 hours to implement these T-MSIS reporting changes. Using the upper range, we estimate a one-time burden of 22,000 hours (44 respondents x 500 hr) at a cost of $2,913,680 (22,000 hr × $135.54/hr). After taking into account enhanced Federal Financial Participation rate of 75 percent for Medicaid Enterprise Systems, we estimate a state share of $728,420 ($2,913,680 x 0.25).

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Annual Cost to Federal Government: $18,500,000

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)? 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: 06/15/2026

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