Medicaid State Program Integrity (SPIA) CMS-10244

Forms and Documents

Document Name	Status
Appendix B - Draft SPIA Data Collection Instrument w_track changes.doc Supplementary Document	2007-10-31
Revisions to SPIA OMB Clearance Package.doc Supplementary Document	2007-10-31
CMS Response to SPIA Comments 10-10-07.doc Supplementary Document	2007-10-31
Appendix E - 42 CFR 455.pdf Supplementary Document	2007-10-31
Appendix D - DRA of 2005 Section 6034.pdf Supplementary Document	2007-10-31
Appendix A - SPIA Case Study Pilot Summary.doc Supplementary Document	2007-10-31
Appendix C - DRAFT Medicaid Integrity Glossary 10-10-07.doc Supplementary Document	2007-10-31
SPIA Supporting Statement revised 10-10-07.doc Supporting Statement A	2007-10-31

IC Document Collections

IC ID	Document Title	Status
182825	Medicaid State Program Integrity Assessment (SPIA) CMS-10244 Other-Information Management System	New

ICR Details

OMB Control No: 0938-1033	ICR Reference No: 200711-0938-013
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicaid State Program Integrity (SPIA) CMS-10244
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/04/2008
	Date Received in OIRA: 11/21/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2011	36 Months From Approved
Responses	56	0	0
Time Burden (Hours)	1,400	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Under the provisions of the Deficit Reduction Act (DRA)of 2005, Congress directed CMS to establish the Medicaid Integrity Program (MIP), CMS's first national strategy to combat Medicaid fraud, waste, and abuse. CMS has two broad responsibilities under the MIP: 1) Review the action of individuals or entities providing services or furnishing items under Medicaid; conducting audits of claims submitted for payment; identifying overpayments; and educating providers and others on payment integrity and quality of care; and (2) Providing effective support and assistance to States to combat Medicaid fraud, waste, and abuse. In order to fulfill these requirements, CMS plans to develop a Medicaid State Program Integrity Assessment (SPIA) system. Through the SPIA system, CMS will identify current Medicaid program integrity (PI) information, develop profiles for each State based on these data, determine areas to provide States with technical support and assistance, and use the data to develop performance measures to assess States' performance in an ongoing manner.

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Authorizing Statute(s): Statute at Large: 42 Stat. 455 Name of Statute: null
   PL: Pub.L. 109 - 171 6034 Name of Law: Medicaid Integrity Program
   Statute at Large: 19 Stat. 1936 Name of Statute: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 41327	07/27/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 60851	10/26/2007
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Medicaid State Program Integrity Assessment (SPIA) CMS-10244

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ICR Summary 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	56	0	0	56	0	0
Annual Time Burden (Hours)	1,400	0	0	1,400	0	0
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: Section 6034 of the Deficit Reduction Act of 2005 established the Medicaid Integrity Program in Section 1936 of the Social Security Act. Specifically, the legislation provided CMS with resources to establish the Medicaid Integrity Program. CMS' first national strategy to detect and prevent Medicaid fraud and abuse.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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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: 11/21/2007

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