Centenarian Project and Medicare Non-Utilzation Project Development Worksheets: Face-to-Face Interview; Telephone Interview

Forms and Documents

Document Name	Status
Supporting Statement - 0780.docx Supporting Statement A	2019-02-18

IC Document Collections

IC ID	Document Title	Status
208156	Medicare Non-utilization Project (MNUP) Other-Interview Worksheet	Modified
191770	Centenarian Project Title XVI Only Other-Interview Worksheet	Modified

ICR Details

OMB Control No: 0960-0780	ICR Reference No: 201811-0960-004
Status: Active	Previous ICR Reference No: 201512-0960-005
Agency/Subagency: SSA	Agency Tracking No:
Title: Centenarian Project and Medicare Non-Utilzation Project Development Worksheets: Face-to-Face Interview; Telephone Interview
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/18/2019
	Date Received in OIRA: 02/18/2019
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2022	36 Months From Approved	06/30/2019
Responses	4,607	0	4,640
Time Burden (Hours)	1,152	0	1,160
Cost Burden (Dollars)	0	0	0

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Abstract: SSA conducts interviews with centenary Title II beneficiaries and Title XVI recipients, and Medicare Non-Utilization Project (MNUP) beneficiaries age 90 and older to: (1) Assess if the beneficiaries are still living; (2) prevent fraud through identity misrepresentation; and (3) evaluate the well-being of the recipients. SSA field office personnel obtain the information through one-time, in-person interviews with the centenarians and MNUP beneficiaries. If the centenarians and MNUP beneficiaries have representatives or caregivers, SSA personnel invite them to the interviews. During these interviews, SSA employees make overall observations of the centenarians, MNUP beneficiaries, and their representative payees (if applicable). The interviewer uses the appropriate Development Worksheet as a guide for the interview, in addition to documenting findings during the interview. Non-completion of the Worksheets, or refusal of the interviews, will result in the suspension of the centenarians’ or MNUP beneficiaries’ payments. SSA conducts the interviews either over the telephone or through a face-to-face discussion with the respondents. Respondents are SSI recipients or Social Security beneficiaries 100 years old or older; MNUP beneficiaries; their representative payees; or their caregivers.

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Authorizing Statute(s): US Code: 42 USC 405 Name of Law: The Social Security Act
   US Code: 42 USC 1383 Name of Law: The Social Security 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:
	83 FR 62943	12/06/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 4597	02/15/2019
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
Centenarian Project Title XVI Only
Medicare Non-utilization Project (MNUP)

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ICR Summary of Burden

	Total Approved	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	4,607	4,640	0	0	-33	0
Annual Time Burden (Hours)	1,152	1,160	0	0	-8	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: In 2010, SSA selected Title II beneficiaries and Title XVI recipients ages 103 years and older for the Centenarian Project. In 2012, SSA changed the age range to 100 years and older; and in 2014, we changed the Centenarian Project to Title XVI recipients only. Since we only conduct these interviews once, the population that still requires interviews continues to decrease. Currently, our records show we only need to conduct 194 more Centenarian reviews. We consider these remaining 194 Centenarian reviews rollover cases. These rollovers consist of Title II and Title XVI records where SSA staff has not, yet, made a successful contact that confirms life or death. Upon completion of these rollover cases, we will discontinue the Centenarian Project. We will notify OMB when the remaining 194 Centenarian rollovers are complete, as this will affect the burden information in #12 above. The MNUP will continue as the official Title II replacement for the Centenarian Project. Currently, our records show 4,413 MNUP beneficiaries who require contact. Our yearly selections identify beneficiaries who do not use their Medicare over a period of time. Medicare usage fluctuates yearly and this influences the number of MNUP respondents. When we last cleared this IC in 2016, the burden of hours was 1,160 hours. However, we are currently reporting a burden of 1,151.75 hours. This change is due to a decrease in the total number of respondents from 4,640 to 4,607. Specifically, there was a reduction in Centenarian respondents who still require an interview from 240 to 194. In addition, there was a slight increase in the number of MNUP respondents that now require an interview from 4,400 to 4,413. There is no change to the burden time per response.

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Annual Cost to Federal Government: $184,253

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? Uncollected

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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: 02/18/2019

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