CMS' regulatory authority to establish reporting requirements for Part C Medicare Advantage (MA) organizations is described in 42 CFR 422.516 (a). It is noted that each MA organization must have an effective procedure to develop, compile, evaluate, and report to CMS, to its enrollees, and to the general public, at the times and in the manner that CMS requires, and while safeguarding the confidentiality of the doctor-patient relationship, statistics and other information with respect to the following:
(1) The cost of its operations.
(2) The patterns of utilization of its services.
(3) The availability, accessibility, and acceptability of its services.
(4) To the extent practical, developments in the health status of its enrollees.
(5) Other matters that CMS may require.
With both growth in the number of participating organizations and the types of plan "packages" available to Medicare beneficiaries, the need for more extensive, in depth, and effective monitoring has increased. Therefore, CMS is requesting a 3 year OMB approval of additional Part C data reporting.
A new data element C was added for Telehealth Reporting for clarification purposes. Despite the additional element there were no changes to the per burden estimate because the number of elements for Telehealth are now equivalent to the number of data elements for the Part C Rewards and Incentives reporting section. However, the number of contracts reporting in 2019 has increased to 594 from 566, accordingly the annual burden was adjusted to 187,926.
$300,000
No
No
No
No
No
No
Uncollected
Stephan McKenzie 410 786-1943 stephan.mckenzie@cms.hhs.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.
CMS Response to 30 day comments.pdf
CMS -10261- Supporting Statement_2.0 Final redline_2.docx
Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a)