OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Redetermination of Eligibility for Help with Medicare Prescription Drug Plan Costs

ICR 200812-0960-012 · OMB 0960-0723 · Historical Active

Forms and Documents
Document
Name
Status
Form and Instruction
 Modified
Form and Instruction
 New
Supporting Statement A
2008-12-31
Supplementary Document
2008-12-22
IC Document Collections
IC ID
Document
Title
Status
9780 Modified
187637 New
ICR Details
0960-0723 200812-0960-012
Historical Active 200805-0960-005
SSA
Redetermination of Eligibility for Help with Medicare Prescription Drug Plan Costs
Revision of a currently approved collection   No
Regular
Approved without change 03/12/2009
Retrieve Notice of Action (NOA) 12/31/2008
The burden accounting has been corrected.
  Inventory as of this Action Requested Previously Approved
03/31/2012 36 Months From Approved 05/31/2009
261,636 0 1,876,000
78,491 0 250,333
0 0 0
As required by the Medicare Modernization Act of 2003 (P.L. 108-173), SSA conducts low-income subsidy eligibility redeterminations for Medicare beneficiaries who filed for the subsidy and were determined by SSA to be eligible. SSA will conduct subsidy eligibility redeterminations under two circumstances: 1) When an individual completes Form SSA-1026-OCR-SM-SCE to report a subsidy-changing event (marriage, separation from a spouse, separated spouses resume living together, divorce, annulment, or death); and 2) When SSA uses Form SSA-1026-OCR-SM-REDE to conduct an annual review of individuals who became entitled during the prior 12 months, an annual review of a percentage of individuals who are eligible for more than 12 months, and a review of individuals who report a change in income, resources, or household size that may affect the subsidy amount. In compliance with P.L. 110-275, SSA will use a new version of Form SSA-1026 beginning in January 2010. In this new version, SSA will eliminate questions about the value of life insurance policies and in-kind support and maintenance. The respondents are current recipients of the Medicare Part D low-income subsidy who will undergo an eligibility redetermination for one of the reasons mentioned above.
US Code: 42 USC 1395w-101 Name of Law: Social Security Act
   PL: Pub.L. 110 - 275 100 Name of Law: Medicare Improvements for Patients and Providers Act of 2008
  
PL: Pub.L. 110 - 275 100 Name of Law: Medicare Improvements for Patients and Providers Act of 2008
Not associated with rulemaking
  73 FR 64004 10/28/2008
73 FR 79537 12/29/2008
No
  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 261,636 1,876,000 0 0 -1,614,364 0
Annual Time Burden (Hours) 78,491 250,333 0 -8,321 -163,521 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Changing Regulations
There is no actual burden increase; there only appears to be one because we had previously included two separate forms under one IC, but have now broken them down here into two ICs. ROCIS registers this as an increase. There is a decrease in the number of respondents (adjustment). Because of the provisions of P.L. 110-275, we eliminated certain questions, reducing the total completion time and the burden hours for this collection.
$30,385
No
No
Uncollected
Uncollected
Uncollected
Uncollected
John Biles 410 965-3758 John.Biles@ssa.gov
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/31/2008