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Federal forms, ICRs, and supporting documents

Information Collection Request

Collection of Encounter Data from Medicare Advantage Organizations (CMS-10340)

ICR 201605-0938-005 · OMB 0938-1152 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Form CMS-10340 Collection of Encounter Data from Medicare Advantage Organizations Form and Instruction Modified Available
Justification for Nonsubstantive Change.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-05-09 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
199936 Collection of Encounter Data from Medicare Advantage Organizations Form and Instruction Modified
ICR Details
0938-1152 201605-0938-005
Historical Inactive 201508-0938-001
HHS/CMS
Collection of Encounter Data from Medicare Advantage Organizations (CMS-10340)
No material or nonsubstantive change to a currently approved collection   No
Regular
Withdrawn and continue 05/17/2016
Retrieve Notice of Action (NOA) 05/10/2016
  Inventory as of this Action Requested Previously Approved
11/30/2017 11/30/2017 04/30/2018
516,493,635 0 516,493,635
34,433 0 34,433
0 0 0
Given the increased importance of the accuracy of our Medicare Advantage risk adjustment methodology, we amended sec. 422.310 in August of 2008 to announce that CMS would collect data from MA organizations regarding each item and service provided to an MA plan enrollee. This would allow CMS to incorporate the Medicare Advantage utilization in the development of risk adjustment models for the Medicare Advantage program.
US Code: 42 USC 1395w-23 Name of Law: Data Collection
   US Code: 42 USC 1395w-23 Name of Law: Risk Adjusted Part D Payment
   US Code: 42 USC 1395w-23 Name of Law: Risk Adjusted Part C Payment
  
None
Not associated with rulemaking
  79 FR 31336 06/02/2014
79 FR 53067 09/05/2014
No
1
IC Title Form No. Form Name
Collection of Encounter Data from Medicare Advantage Organizations CMS-10340 Contract and Contact Verification Form
No
No
$25,010,000
No
No
No
No
No
Uncollected
Mitch Bryman 410 786-5258 [email protected]
  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.
05/10/2016