Medicare Advantage Program and Supporting Regulations (CMS-R-267)

Forms and Documents

Document Name	Status
CMS-R-267 (version 2).docx Supporting Statement A	2019-03-15

IC Document Collections

IC ID	Document Title	Status
8462	Medicare Advantage Program and Supporting Regulations (MAOs)	Modified
185236	Medicare Advantage Program and Supporting Regulations (Beneficiaries)	Modified

ICR Details

OMB Control No: 0938-0753	ICR Reference No: 201903-0938-007
Status: Historical Inactive	Previous ICR Reference No: 201804-0938-017
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Medicare Advantage Program and Supporting Regulations (CMS-R-267)
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: 05/06/2019
	Date Received in OIRA: 03/15/2019
Terms of Clearance: Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2021	36 Months From Approved	12/31/2021
Responses	35,596,762	0	35,596,762
Time Burden (Hours)	9,451,489	0	9,451,489
Cost Burden (Dollars)	0	0	0

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Abstract: Medicare Advantage (MA) organizations (formerly M+C organizations) and potential MA organizations (applicants) use the information collected based on the regulations at 42 CFR 422 to comply with the application requirements and the MA contract requirements. CMS uses the information collected based on the regulations at 42 CFR 422 to approve contract applications, monitor compliance with contract requirements, make proper payment to MA organizations, determine compliance with the new prescription drug benefit requirements established by the MMA, and to ensure that correct information is disclosed to Medicare beneficiaries, both potential enrollees and enrollees.

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Authorizing Statute(s): Statute at Large: 18 Stat. 1851 Name of Statute: null
   Statute at Large: 18 Stat. 1859 Name of Statute: null
  

Citations for New Statutory Requirements: Statute at Large: 18 Stat. 1851 Name of Statute: null
Statute at Large: 18 Stat. 1859 Name of Statute: null

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT59	Proposed rulemaking	83 FR 54982	11/01/2018

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 54982	11/01/2018
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Medicare Advantage Program and Supporting Regulations (MAOs)
Medicare Advantage Program and Supporting Regulations (Beneficiaries)

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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: No

Burden Reduction Due to:

Short Statement: Proposes to add new provisions at sections 422.2, 422.60, 422.102, 422.107, 422.111, and 422.752 to establish minimum criteria for Medicare and Medicaid integration in D-SNPs. proposes to modify and add sections 422.560 – 562, 422.566, 422.629 – 634, 438.210, 438.400, and 438.402 to unify Medicare and Medicaid grievance and plan-level appeals processes for certain D-SNPs and affiliated Medicaid managed care plans.

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Annual Cost to Federal Government: $10,000,000

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]? 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: 03/15/2019

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