Medicare and Medicaid; Programs For All-Inclusive Care For The Elderly (PACE) Contained in 42 CFR Part 460 (CMS-R-244)

Forms and Documents

Document Name	Status
CMS-R-244 (CMS-4201-P version 10).docx Supporting Statement A	2023-10-23

IC Document Collections

IC ID	Document Title	Status
8559	Requirements for PACE Entities	Modified
46621	State Requirements	Unchanged

ICR Details

OMB Control No: 0938-0790	ICR Reference No: 202303-0938-014
Status: Received in OIRA	Previous ICR Reference No: 202210-0938-012
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Medicare and Medicaid; Programs For All-Inclusive Care For The Elderly (PACE) Contained in 42 CFR Part 460 (CMS-R-244)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/23/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2023
Responses	144,837	121,407
Time Burden (Hours)	138,809	97,069
Cost Burden (Dollars)	0	0

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Abstract: PACE organizations must demonstrate their ability to provide quality community-based care for the frail elderly who meet their State's nursing home eligibility standards using capitated payments from Medicare and the state. The model of care includes as core services the provision of adult day health care and multidisciplinary team case management, through which access to and allocation of all health services is controlled. Physician, therapeutic, ancillary, and social support services are provided in the participant's residence or on-site at the adult day health center. PACE programs must provide all Medicare and Medicaid covered services including hospital, nursing home, home health, and other specialized services. Financing of this model is accomplished through prospective capitation of both Medicare and Medicaid payments.

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Authorizing Statute(s): US Code: 42 USC 1395eee Name of Law: PAYMENTS TO, AND COVERAGE OF BENEFITS UNDER PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
   PL: Pub.L. 108 - 173 902 Name of Law: Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA)
   US Code: 42 USC 1396U-4 Name of Law: PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
   PL: Pub.L. 105 - 33 4801 Name of Law: the Balanced Budget Act of 1997
   PL: Pub.L. 106 - 554 903 Name of Law: Medicare, Medicaid and SCHIP Benefits Improvement Act of 2000
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AU96	Proposed rulemaking	87 FR 79452	12/27/2022

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 79452	12/27/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Requirements for PACE Entities
State Requirements

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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	144,837	121,407	0	23,430	0	0
Annual Time Burden (Hours)	138,809	97,069	0	41,740	0	0
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: No

Burden Reduction Due to:

Short Statement: The proposed rule addresses various requirements, reduces administrative burden, and provides additional participant protections. The revisions streamlined service determination request extension notifications to reduce administrative burden while building in participant protections including enhanced participant rights requirements; enhanced grievance process requirements, timeframes for arranging and scheduling services, and the development of a risk tool for medical clearance, and added flexibility regarding the maintenance of medical records and communications related to participant’s care, health, or safety. While the rule makes no changes to our State burden estimates, it would revise our private sector burden by 4 respondents, 23,430 responses, and 41,740 hours.

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Annual Cost to Federal Government: $10,341

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]? 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: 10/23/2023

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