Children's Health Insurance Program Managed Care and Supporting Regulations (CMS-10554)

Forms and Documents

Document Name	Status
CMS-10554 - Supporting Statement A [rev 08-07-2016 by OSORA PRA].docx Supporting Statement A	2018-11-19

IC Document Collections

IC ID	Document Title	Status
216803	State Requirements and Burden	Modified
216798	Private Sector Requirements and Burden	Modified

ICR Details

OMB Control No: 0938-1282	ICR Reference No: 201811-0938-004
Status: Active	Previous ICR Reference No: 201505-0938-015
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: Children's Health Insurance Program Managed Care and Supporting Regulations (CMS-10554)
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: 03/26/2019
	Date Received in OIRA: 11/19/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2022	36 Months From Approved
Responses	2,735,906	0	0
Time Burden (Hours)	410,989	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: CHIP enrollees use the information collected and reported as a result of this regulation to make informed choices regarding health care, including how to access health care services and the grievance and appeal system. States use the information collected and reported as part of contracting processes with managed care entities, as well as its compliance oversight role. CMS uses the information collected and reported in an oversight role of State CHIP managed care programs and CHIP state agencies.

---

Authorizing Statute(s): PL: Pub.L. 111 - 5 5006 Name of Law: American Recovery and Reinvestment Act of 2009
   PL: Pub.L. 111 - 148 6401 Name of Law: Patient Protection and Affordable Care Act
   PL: Pub.L. 111 - 3 403 Name of Law: Children’s Health Insurance Program Reauthorization Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 3 403 Name of Law: Children’s Health Insurance Program Reauthorization Act
PL: Pub.L. 111 - 5 5006 Name of Law: American Recovery and Reinvestment Act of 2009
PL: Pub.L. 111 - 148 6401 Name of Law: Patient Protection and Affordable Care Act

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AS25	Final or interim final rulemaking	81 FR 27498	05/06/2016

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 31098	06/01/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 27498	05/06/2016
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Private Sector Requirements and Burden
State Requirements and Burden

---

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	2,735,906	0	2,735,906	0	0	0
Annual Time Burden (Hours)	410,989	0	410,989	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: This is a new collection of information request. Our overarching goal of these provisions is to align CHIP managed care standards with those of the Marketplace and Medicaid where practical to ensure consistency across programs. We are revising existing Medicaid regulations in order to modernize managed care contracting and service delivery while improving health care outcomes and beneficiary experience in a cost-effective manner. To the extent appropriate, the final provisions for CHIP are aligned with the revisions made for Medicaid.

---

Annual Cost to Federal Government: $20,800,000

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)? Yes

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(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: 11/19/2018

---