OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Programs of All-Inclusive Care for the Elderly (PACE) 2020 Audit Protocol (CMS-10630)

ICR 201911-0938-013 · OMB 0938-1327 · Active

Forms and Documents
Document
Name
Status
Form
 Modified
Supplementary Document
2020-01-29
Supplementary Document
2020-01-29
Supporting Statement A
2020-01-29
Supplementary Document
2019-11-26
Supplementary Document
2019-11-26
IC Document Collections
IC ID
Document
Title
Status
225129 Modified
ICR Details
0938-1327 201911-0938-013
Active 201612-0938-020
HHS/CMS CM-CPC
Programs of All-Inclusive Care for the Elderly (PACE) 2020 Audit Protocol (CMS-10630)
Revision of a currently approved collection   No
Regular
Approved with change 02/04/2020
Retrieve Notice of Action (NOA) 12/04/2019
OMB approves this package for three years consistent with the understanding the CMS will collect more data on the burden of audits for PACE organizations to inform future packages.
  Inventory as of this Action Requested Previously Approved
02/28/2023 36 Months From Approved 03/31/2020
35 0 72
21,000 0 17,280
0 0 0
42 CFR 460.190 and 460.192 described CMS’s regulatory authority to monitor, through audit or other means, the Programs for All-Inclusive Care of the Elderly (PACE). This monitoring includes review of books, contracts, medical records, patient care documentation and any other records that pertain to any aspect of services performed, reconciliation of benefit liabilities, and determination of amounts payable. CMS developed a strategy to address our oversight and audit responsibilities. We have combined both the trial year and ongoing audit protocols into one universal audit protocol that is streamlined and outcomes based to reduce the financial and administrative burdens for both CMS and PACE organizations.
US Code: 42 USC 1395eee Name of Law: Social Security Act
   US Code: 42 USC 1396u–4 Name of Law: Social Security Act
  
None
Not associated with rulemaking
  84 FR 9526 03/15/2019
84 FR 65396 11/27/2019
Yes
1
IC Title Form No. Form Name
Trial Year and Routine Audits CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630, CMS-10630 Clinical Appropriateness and Care Planning Impact Analysis Template ,   Clinical Appropriateness and Care Planning Impact Analysis Template ,   Appeals Impact Analysis Template ,   Clinical Appropriateness and Care Planning Impact Analysis Template ,   Clinical Appropriateness and Care Planning Impact Analysis Template ,   Root Cause Analysis Template ,   Personnel Impact Analysis Template ,   Appeals Impact Analysis Template ,   Clinical Appropriateness and Care Planning Impact Analysis Template ,   PACE Audit Process and Data Request Protocol ,   PACE Supplemental Questionnaire ,   Summary of any pre-audit issues ,   Onsite Audit ,   Audit Survey ,   Clinical Appropriateness and Care Planning Impact Analysis Template ,   Service Delivery Request and Appeals Impact Analysis Template ,   Grievances Impact Analysis Template ,   Clinical Appropriateness and Care Planning Impact Analysis Template ,   Clinical Appropriateness and Care Planning Impact Analysis Template ,   Service Delivery Request Impact Analysis Template ,   Service Delivery Request Impact Analysis Template ,   Clinical Appropriateness and Care Planning Impact Analysis Template
  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 35 72 0 -37 0 0
Annual Time Burden (Hours) 21,000 17,280 0 3,720 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Collection documents have increased from 18 documents in the 2017 audit protocol to 22 documents. The total burden per audit for each PACE organization has increased from of 240 hours to 600 hours due to assuming that all four PACE organization individuals identified will work simultaneously during the audit and each person will work 150 hours. This burden estimates for 2020 will accurately reflect the burden for PACE organizations and the government when undergoing an audit. New regulation has gone into effect which allows CMS to conduct ongoing audits using a risk assessment. This new regulation allows CMS to reduce the number of audits conducted annually from approximately 70 audits a year to approximately 35 audits a year.
$5,247,020
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.
12/04/2019