Notice2025-10824
Medicaid and Children's Health Insurance Program (CHIP) Generic Information Collection Activities: Proposed Collection; Comment Request
Primary source
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Published
June 13, 2025
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
On May 28, 2010, the Office of Management and Budget (OMB) issued Paperwork Reduction Act (PRA) guidance related to the "generic" clearance process. Generally, this is an expedited process by which agencies may obtain OMB's approval of collection of information requests that are "usually voluntary, low-burden, and uncontroversial collections," do not raise any substantive or policy issues, and do not require policy or methodological review. The process requires the submission of an overarching plan that defines the scope of the individual collections that would fall under its umbrella. This Federal Register notice seeks public comment on one or more of our collection of information requests that we believe are generic and fall within the scope of the umbrella. Interested persons are invited to submit comments regarding our burden estimates or any other aspect of this collection of information, including: the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.
Full Text
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<title>Federal Register, Volume 90 Issue 113 (Friday, June 13, 2025)</title>
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[Federal Register Volume 90, Number 113 (Friday, June 13, 2025)]
[Notices]
[Pages 25045-25046]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-10824]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-10398 #37, #87, and #93]
Medicaid and Children's Health Insurance Program (CHIP) Generic
Information Collection Activities: Proposed Collection; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, Health and Human
Services (HHS).
ACTION: Notice.
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SUMMARY: On May 28, 2010, the Office of Management and Budget (OMB)
issued Paperwork Reduction Act (PRA) guidance related to the
``generic'' clearance process. Generally, this is an expedited process
by which agencies may obtain OMB's approval of collection of
information requests that are ``usually voluntary, low-burden, and
uncontroversial collections,'' do not raise any substantive or policy
issues, and do not require policy or methodological review. The process
requires the submission of an overarching plan that defines the scope
of the individual collections that would fall under its umbrella. This
Federal Register notice seeks public comment on one or more of our
collection of information requests that we believe are generic and fall
within the scope of the umbrella. Interested persons are invited to
submit comments regarding our burden estimates or any other aspect of
this collection of information, including: the necessity and utility of
the proposed information collection for the proper performance of the
agency's functions, the accuracy of the estimated burden, ways to
enhance the quality, utility and clarity of the information to be
collected, and the use of automated collection techniques or other
forms of information technology to minimize the information collection
burden.
DATES: Comments must be received by June 27, 2025.
ADDRESSES: When commenting, please reference the applicable form number
(CMS-10398 #__) and the OMB control number (0938-1148). To be assured
consideration, comments and recommendations must be submitted in any
one of the following ways:
1. Electronically. You may send your comments electronically to
<a href="http://www.regulations.gov">http://www.regulations.gov</a>. Follow the instructions for ``Comment or
Submission'' or ``More Search Options'' to find the information
collection
[[Page 25046]]
document(s) that are accepting comments.
2. By regular mail. You may mail written comments to the following
address: CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development, Attention: CMS-10398 #__/OMB
control number: 0938-1148, Room C4-26-05, 7500 Security Boulevard,
Baltimore, MD 21244-1850.
To obtain copies of a supporting statement and any related forms
for the proposed collection(s) summarized in this notice, please access
the CMS PRA website by copying and pasting the following web address
into your web browser: <a href="https://www.cms.gov/medicare/regulations-guidance/legislation/paperwork-reduction-act-1995/pra-listing">https://www.cms.gov/medicare/regulations-guidance/legislation/paperwork-reduction-act-1995/pra-listing</a>.
FOR FURTHER INFORMATION CONTACT: William N. Parham at 410-786-4669.
SUPPLEMENTARY INFORMATION: Following is a summary of the use and burden
associated with the subject information collection(s). More detailed
information can be found in the collection's supporting statement and
associated materials (see ADDRESSES).
Generic Information Collection
1. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicaid Managed
Care Rate Development Guide; Use: States must submit to CMS for review
and approval all rate certifications for managed care plans. The
state's actuary is responsible for certifying that the managed care
program's capitation rates are actuarially sound for a specific time
period and documents the rate development process and the final
certified capitation rates in a rate certification. The Medicaid
Managed Care Rate Development Guides outline the rate development
standards and CMS' expectations for documentation included in rate
certifications such as descriptions of base data used, trend factors to
base data, projected benefit and non-benefit costs, and any other
considerations or adjustments used when setting capitation rates. Form
Number: CMS-10398 #37 (OMB control number: 0938-1148); Frequency: Once
and Occasionally; Affected Public: State, Local, or Tribal Governments;
Number of Respondents: 47; Total Annual Responses: 137; Total Annual
Hours: 754. (For policy questions regarding this collection contact:
Rebecca Burch Mack at 303-844-7355.)
2. Type of Information Collection Request: New information
collection request; Title of Information Collection: Managed Care Plan
(MCP) Medical Loss Ratio (MLR) Reporting Template; Use: Medicaid
managed care is the predominant delivery system for Medicaid
beneficiaries to access health care services. State Medicaid agencies
contract with managed care plans that accept a fixed, prospective
monthly payment for each enrolled beneficiary (also referred to as
risk-based managed care). Section 1903(m)(2) of the Social Security Act
(SSA) and 42 CFR 438.4 require that capitation rates be actuarially
sound, meaning that the capitation rates are projected to provide for
all reasonable, appropriate, and attainable costs that are required
under the terms of the contract and for the operation of the MCP for
the time period and the population covered under the terms of the
contract. The MLR is a key measure of MCP financial performance and
indicates the share of premium revenue (capitation payments) that a
plan spends on covered health services and activities to improve health
care quality compared to the share of revenue to cover administrative
expenses and profit/surplus. MLRs are used as a retrospective tool to
assess financial performance of MCPs. Section 438.8 provides detail on
MLR calculations and MCP reporting requirements.
Section 438.8(k) requires State contracts with MCPs to include a
requirement to annually report to the state specific details of the
plan's MLR. The attached Medicaid managed care plan MLR reporting
template provides States with a standard format for collecting the
required details from their contracted MCPs. States are not required to
have their MCPs use this template; it is provided in response to
States' requests for a streamlined, consistent way to collect the
required information. CMS' review process for managed care MLR
represents an essential federal oversight function to ensure that
States and MCPs are compliant with applicable federal laws and
regulations.
Form Number: CMS-10398 #87 (OMB control number: 0938-1148);
Frequency: Yearly; Affected Public: Private Sector and State, Local, or
Tribal Governments; Number of Respondents: 47; Total Annual Responses:
47; Total Annual Hours: 2,350. (For policy questions regarding this
collection contact: Amy Gentile at 410-786-3499.)
3. Type of Information Collection Request: New information
collection request; Title of Information Collection: Medicaid 1915(l)
State Plan Option to Provide Medical Assistance for Eligible
Individuals Who Are Patients in Eligible Institutions for Mental
Diseases; Use: On March 9, 2024, section 204 of the Consolidated
Appropriations Act amended section 1915(l) of the SSA to remove the end
date of September 30, 2023, making 1915(l) a permanent optional state
plan benefit, and making additional changes to the requirements for
maintenance of effort review process for eligible institutions of
mental disease, patient placement and utilization management, and
provider assessments.
The template is necessary for States to submit a state plan
amendment on or before December 31, 2025, for an October 1, 2025,
effective date. States will need adequate time to complete and vet
these documents. If states do not have template, it could result in
states not paying for such services, and beneficiaries not being able
to receive such services. The longer the package update goes
unpublished the likelihood of states missing the deadline increases.
Form Number: CMS-10398 #93 (OMB control number: 0938-1148);
Frequency: Once and Occasionally; Affected Public: State, Local, or
Tribal Governments; Number of Respondents: 56; Total Annual Responses:
56; Total Annual Hours: 1,400. (For policy questions regarding this
collection contact: Marlana Thieler at 410-786-6274.)
William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts,
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2025-10824 Filed 6-12-25; 8:45 am]
BILLING CODE 4120-01-P
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