Medicaid and Children's Health Insurance Plan (CHIP) Managed Care

Forms and Documents

Document Name	Status
CMS-10178.Supporting Statement Part B.doc Supporting Statement B	2009-09-25
CMS-10178.Supporting Statement Part A.doc Supporting Statement A	2009-09-25

IC Document Collections

IC ID	Document Title	Status
43679	Medicaid and Children's Health Insurance Plan (CHIP) Managed Care	Modified

ICR Details

OMB Control No: 0938-0994	ICR Reference No: 200909-0938-007
Status: Historical Active	Previous ICR Reference No: 200711-0938-005
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicaid and Children's Health Insurance Plan (CHIP) Managed Care
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/06/2009
	Date Received in OIRA: 09/29/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2012	36 Months From Approved	11/30/2009
Responses	28,050	0	23,400
Time Burden (Hours)	28,050	0	23,400
Cost Burden (Dollars)	0	0	0

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Abstract: Payment Error Rate Measurement (PERM) is established to comply with Improper Payment Information Act (IPIA) of 2002. The program measures improper payments in both Medicaid and State Children's Health Insurance Program (SCHIP). Each PERM cycle will measure payment errors in 17 randomly selected states, so that each state will be measured once every three years. PERM measure three components in each program: fee-for-service, managed care, and eligibility. The payment error in the three components will be combined to calculate an annual payment error rate in Medicaid and CHIP.

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Authorizing Statute(s): PL: Pub.L. 107 - 300 1902 Name of Law: Improper Payment Information Act (IPIA) of 2002
  

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:
	74 FR 36717	07/24/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 48792	09/25/2009
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
Medicaid and Children's Health Insurance Plan (CHIP) Managed Care

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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	28,050	23,400	0	4,650	0	0
Annual Time Burden (Hours)	28,050	23,400	0	4,650	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: This is a revision of a current approved collection with minor adjusted information requirement collection. There is a 10-hour increase in burden per State per program as part of a new process. Based on the past experience in PERM operation, the adjustment is made to ensure the quality of the data will comply with the data requirement during the measurement.

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Annual Cost to Federal Government: $5,275,571

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

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)? No

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: 09/29/2009

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