Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment (CMS-10401)

Forms and Documents

Document Name	Status
CMS-10401 - Supporting Statement - 30-dayf.docx Supporting Statement A	2022-07-06

IC Document Collections

IC ID	Document Title	Status
254458	Cost-sharing Requirements 156.130(d)	New
254457	Data requirements (§ 153.710(d))	New
211711	Confirmation of Interim Reports (153.710)	Removed
211710	Initial Validation Audit Identification and Inter-rater Reliability Report (153.630(b)(1) and (b)(8)	Removed
211709	Risk Adjustment Data Validation (153.630)	Removed
211708	Supplemental Diagnosis (153.700(a))	Modified
211707	Risk adjustment and reinsurance distributed data collection (153.700(a))	Modified
211675	Administrative Burden Related to Audits of the Risk Adjustment Covered Issuers (§153.410(d); §153.620(c))	Removed
211674	Risk Corridors Data Validation (153.530 and 153.540)	Removed
211663	Adminstative Appeals for Premium Stabilization Program, Federal Exchange User Fees, Premium Tax Credits and Costs Sharing Reductions (156.1220)	Removed
208838	Calculation of Reinsurance Contributions	Removed
208837	Upload of Risk Adjustment and Reinsurance Data for Masked Enrollee Identification Number (153.700(a))	Modified
198554	Health Insurance Issuer Standards Related to the Transitional Reinsurance Program (153.400-153.410)	Removed

ICR Details

OMB Control No: 0938-1155	ICR Reference No: 202207-0938-001
Status: Received in OIRA	Previous ICR Reference No: 201405-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment (CMS-10401)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/11/2022

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	3,250	0
Time Burden (Hours)	4,126,850	0
Cost Burden (Dollars)	0	0

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Abstract: The reinsurance program, risk corridors program, and risk adjustment program support the effective functioning of the American Health Benefit Exchanges ("Exchanges"), which will become operational by January 1, 2014. The program also mitigate the negative impacts of adverse selection and market uncertainty.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1321; 1341; 1342; 1343 Name of Law: Affordable Care Act
  

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 5483	02/01/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 32027	05/26/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Administrative Burden Related to Audits of the Risk Adjustment Covered Issuers (§153.410(d); §153.620(c))
Adminstative Appeals for Premium Stabilization Program, Federal Exchange User Fees, Premium Tax Credits and Costs Sharing Reductions (156.1220)
Calculation of Reinsurance Contributions
Confirmation of Interim Reports (153.710)
Cost-sharing Requirements 156.130(d)
Data requirements (§ 153.710(d))
Health Insurance Issuer Standards Related to the Transitional Reinsurance Program (153.400-153.410)
Initial Validation Audit Identification and Inter-rater Reliability Report (153.630(b)(1) and (b)(8)
Risk Adjustment Data Validation (153.630)
Risk Corridors Data Validation (153.530 and 153.540)
Risk adjustment and reinsurance distributed data collection (153.700(a))
Supplemental Diagnosis (153.700(a))
Upload of Risk Adjustment and Reinsurance Data for Masked Enrollee Identification Number (153.700(a))

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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	3,250	0	0	-5,761,574	-731,146	6,495,970
Annual Time Burden (Hours)	4,126,850	0	0	-13,851,574	-1,672,162	19,650,586
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This reinstatement with change includes a significant decrease in burden due to the termination of the risk corridors program, from 19,650,586 to 4,126,850 hours. Also, based on the past years of experience with the risk adjustment program (including HHS-RADV), we substantially reduced the number of issuers participating in the risk adjustment program by more than two thirds, to 650 from 2,400.

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Annual Cost to Federal Government: $66,696,518

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]? Yes

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: 07/11/2022

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