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.
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Plan sponsors are required have procedures to voluntarily self-report potential fraud or misconduct related to the MA and Part D programs, respectively, to CMS or its designee. Section 6063 of the SUPPORT Act requires the Secretary of HHS to establish a secure web-based program integrity portal (or other successor technology) that would allow secure communication among the Secretary, MA and Part D plan sponsors, as well as eligible entities with a contract under section 1893, such as Medicare program integrity contractors. The purpose is to enable, through the portal: the referral by such plans of substantiated or suspicious activities (as defined by the Secretary) of a provider of services (including a prescriber) or supplier related to fraud, waste, and abuse for the purpose of initiating or assisting investigations conducted by the eligible entity; and data sharing among such MA plans, prescription drug plans, and the Secretary. CMS plans to utilize a module within the Health Plan Management System (HPMS) as the program integrity portal for information collection and dissemination. Such data and the regular submission and dissemination of this important information would, in our view, strengthen CMS’ ability to oversee plan sponsors’ efforts to maintain an effective fraud, waste, and abuse program.
Section 6063 also requires MA plans and Medicare prescription drug plans to report any information related to the inappropriate prescribing of opioids and concerning investigations, credible evidence of suspicious activities of a provider of services (including a prescriber) or supplier, and other actions taken by the plan.
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-10724 - Supporting Statement A (2020 CMS-4190-P version 5).docx
Subsequent Years