Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204 (CMS-10391)

Forms and Documents

Document Name	Status
CMS-10391 - Supporting Statement A (rev 04-25-2018 by OSORA PRA) CLEAN.doc Supporting Statement A	2018-04-25

IC Document Collections

IC ID	Document Title	Status
230976	Exemption for States with High Managed Care Enrollment (§§447.203(b) and 447.204(a) through (c))	New
218857	Public Process to Engage Stakeholders (on-going burden) (sec. 447.204(a)(1) and (2))	Modified
218855	Beneficiary Feedback Mechanism (on-going burden) (sec. 447.203(b)(7))	Unchanged
218854	Access Monitoring Review Plan (on-going burden) (sec. 447.203(b)(1) - (5))	Removed
197692	Public Process to Engage Stakeholders (one-time burden) (sec. 447.204(a)(1) and (2))	Modified
197691	Corrective Action Plan (one-time requirement) (sec. 447.203(b)(8))	Modified
197690	Beneficiary Feedback Mechanism (one-time burden) (sec. 447.203(b)(7))	Modified
197689	Access Monitoring Procedures Following Rate Reduction SPA (sec. 447.203(b)(6)(ii))	Modified
197688	Access Monitoring Review Plan (one-time burden) (sec. 447.203(b)(1) - (5))	Removed

ICR Details

OMB Control No: 0938-1134	ICR Reference No: 201804-0938-004
Status: Historical Inactive	Previous ICR Reference No: 201604-0938-008
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204 (CMS-10391)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 09/18/2018
	Date Received in OIRA: 04/26/2018
Terms of Clearance: This ICR was submitted one month after publication of the NPRM. Please submit ICRs simultaneously (within a day or two) of publication of the related rulemaking in the Federal Register.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	36 Months From Approved	04/30/2019
Responses	212	0	212
Time Burden (Hours)	30,501	0	30,501
Cost Burden (Dollars)	0	0	0

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Abstract: The information will be used by states to document that access to care is provided in compliance with section 1902(a)(30)(A) of the Act, to identify issues with access within a state’s Medicaid program, and to inform any necessary programmatic changes to address issues with access to care. CMS will use the information to make informed approval decisions on State plan amendments that propose to make Medicaid rate reductions or restructure payment rates and to provide the necessary information for CMS to monitor ongoing compliance with section 1902(a)(30)(A). Beneficiaries, providers and other affected stakeholders will use the information to raise access issues to state Medicaid agencies and work with agencies to address those issues.

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Authorizing Statute(s): Statute at Large: 42 Stat. 1902 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:
0938-AT41	Proposed rulemaking	83 FR 12696	03/23/2018

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 12696	03/23/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

IC Title	Form No.	Form Name
Access Monitoring Review Plan (on-going burden) (sec. 447.203(b)(1) - (5))
Access Monitoring Review Plan (one-time burden) (sec. 447.203(b)(1) - (5))
Exemption for States with High Managed Care Enrollment (§§447.203(b) and 447.204(a) through (c))
Beneficiary Feedback Mechanism (on-going burden) (sec. 447.203(b)(7))
Public Process to Engage Stakeholders (on-going burden) (sec. 447.204(a)(1) and (2))
Access Monitoring Procedures Following Rate Reduction SPA (sec. 447.203(b)(6)(ii))
Beneficiary Feedback Mechanism (one-time burden) (sec. 447.203(b)(7))
Corrective Action Plan (one-time requirement) (sec. 447.203(b)(8))
Public Process to Engage Stakeholders (one-time burden) (sec. 447.204(a)(1) and (2))

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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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The NPRM provides an exemption to the regulatory requirements in §§ 447.203(b)(1) – (6) and 447.204(a) – (c) for states with comprehensive, risk-based Medicaid managed care enrollment rates above 85% of the total covered population under a state’s Medicaid program. It also provides an exemption to the regulatory requirements in §§ 447.203(b)(6) and 447.204(a) – (c) for states that submit SPAs to reduce or restructure payments where the overall reduction is 4% or less of overall spending within the affected state plan service category for a single state fiscal year and 6% or less over two consecutive state fiscal years. It also modifies the requirements in § 447.204(b)(2) so that, for SPAs that reduce or restructure Medicaid payment rates, states would be required to submit to CMS an assurance that data indicates current access is consistent with the requirements of the Social Security Act instead of an analysis anticipating the effects of a proposed change in payment rates or structure.

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Annual Cost to Federal Government: $0

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]? 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? 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: 04/26/2018

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