Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204 (CMS-10391)

Forms and Documents

Document Name	Status
Response to Public Comments.docx Supplementary Document	2022-04-28
CMS-10391 - Supporting Statement A (2022 version 3).docx Supporting Statement A	2022-04-28

IC Document Collections

IC ID	Document Title	Status
218857	Public Process to Engage Stakeholders (on-going burden) (sec. 447.204(a)(1) and (2))	Unchanged
218855	Beneficiary Feedback Mechanism (on-going burden) (sec. 447.203(b)(7))	Unchanged
218854	Access Monitoring Review Plan (on-going burden) (sec. 447.203(b)(1) - (5))	Unchanged
197692	Public Process to Engage Stakeholders (one-time burden) (sec. 447.204(a)(1) and (2))	Unchanged
197691	Corrective Action Plan (sec. 447.203(b)(8))	Unchanged
197689	Access Monitoring Procedures Following Rate Reduction SPA (sec. 447.203(b)(6)(ii))	Unchanged

ICR Details

OMB Control No: 0938-1134	ICR Reference No: 202204-0938-010
Status: Received in OIRA	Previous ICR Reference No: 201812-0938-020
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204 (CMS-10391)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 04/28/2022

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2022
Responses	202	202
Time Burden (Hours)	23,898	23,898
Cost Burden (Dollars)	0	0

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Abstract: CMS-2328-FC requires a transparent, data-driven process for states to document that Medicaid beneficiaries have access to services covered under the Medicaid State plan to the extent that services are available to the general population in a geographic area. To meet the requirements of the final rule, states must conduct access review monitoring plans that measure: the extent that enrollee needs are met, the availability of care and qualified providers, service utilization and payment rate comparisons. The reviews will be conducted every three years for: primary care, physician specialists, behavorial health, and pre and post natal obstetric services (including labor and delivery). As states reduce or restructure provider payment rates or receive significant numbers of complaints from providers and beneficiaires about access to care, additional services must be included in the review plan and monitored for at least 3 years. We are soliciting comments on the services required for ongoing access reviews and the timelines associated with review and monitoring activities. The final rule also requires states have mechanisms for obtaining beneficiary and provider feedback on access to care, such as hotlines, surveys, ombudsman or other equivalent mechanisms and institute corrective action procedures should access issues be discovered through the access review and monitoring processes. Finally, when considering reductions to Medicaid payment rates the final rule requires states to undertake a process that gathers input from stakesholds and relies upon the information analyzed through the data reveiws on the proposed reduction or restructuring of Medicaid service payment rates.

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Authorizing Statute(s): Statute at Large: 42 Stat. 1902
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 9627	02/22/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 25273	04/28/2022
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
Access Monitoring Procedures Following Rate Reduction SPA (sec. 447.203(b)(6)(ii))
Access Monitoring Review Plan (on-going burden) (sec. 447.203(b)(1) - (5))
Beneficiary Feedback Mechanism (on-going burden) (sec. 447.203(b)(7))
Corrective Action Plan (sec. 447.203(b)(8))
Public Process to Engage Stakeholders (on-going burden) (sec. 447.204(a)(1) and (2))
Public Process to Engage Stakeholders (one-time burden) (sec. 447.204(a)(1) and (2))

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ICR Summary of Burden

	Total Request	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	202	202	0	0	0	0
Annual Time Burden (Hours)	23,898	23,898	0	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:

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Annual Cost to Federal Government: $0

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.     Yes

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? No

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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: 04/28/2022

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