Program Integrity Portal FWA Reporting Module - Part D Plans (CMS-10517)

Forms and Documents

Document Name	Status
CMS-10517 - Supporting Statement A (2020 CMS-4190-P version 5).docx Supporting Statement A	2020-02-20

IC Document Collections

IC ID	Document Title	Status
240035	Subsequent Years	New
212416	Initial Year	Modified

ICR Details

OMB Control No: 0938-1262	ICR Reference No: 202001-0938-010
Status: Received in OIRA	Previous ICR Reference No: 201411-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No: CPI
Title: Program Integrity Portal FWA Reporting Module - Part D Plans (CMS-10517)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 02/21/2020

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	126	0
Time Burden (Hours)	25,389	0
Cost Burden (Dollars)	0	0

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Abstract: Formerly known as the Predictive Learning Analytics Tracking Outcome (PLATOTM) which is no longer operational. Section 6063 of the SUPPORT ACT requires HHS to establish a secure web-based program integrity portal (or other successor technology) that would allow secure communication among the Secretary, MA and Part D plan sponsors, as well as eligible entities with a contract under section 1893, such as Medicare program integrity contractors. The program integrity portal would serve as the core repository for the data addressed in sections 2008 and 6063 of the SUPPORT Act. These provisions of the SUPPORT Act require Part D plan sponsors to have procedures to identify, and must report to CMS or its designee either of the following: any payment suspension implemented by a plan, pending investigation of credible allegations of fraud by a pharmacy, which must be implemented in the same manner as the Secretary does under section 1862(o)(1) of the Act; and any information related to the inappropriate prescribing of opioids and concerning investigations, credible evidence of suspicious activities of a provider of services (including a prescriber) or supplier, and other actions taken by the plan. The required data shall be submitted via the program integrity portal. In addition, the plans may report a referral, through the portal, of substantiated or suspicious activities of a provider of services (including a prescriber) or a supplier related to fraud, waste and abuse to initiate or assist with investigations conducted by CMS, or its designee, a Medicare program integrity contractor, or law enforcement partners.

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Authorizing Statute(s): PL: Pub.L. 115 - 271 6063(a)(i)(1) Name of Law: SUPPORT Act
   PL: Pub.L. 115 - 271 6063(b) Name of Law: SUPPORT Act
   PL: Pub.L. 115 - 271 2008 Name of Law: SUPPORT Act
  

Citations for New Statutory Requirements: PL: Pub.L. 108 - 173 Title I Name of Law: Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA)

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT97	Proposed rulemaking	85 FR 9002	02/18/2020

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 9002	02/18/2020
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
Subsequent Years
Initial Year

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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	126	0	-1,424	0	0	1,550
Annual Time Burden (Hours)	25,389	0	6,789	0	0	18,600
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: This 2020 collection of information request proposes to reinstate – with change – our 0938-1262 control number that was associated with PLATO™ (Predictive Learning Analytics Tracking Outcome) which is no longer operational. The reinstatement is associated with our February 18, 2020 (85 FR 9002) proposed regulatory changes (CMS-4190-P, RIN 0938-AT97) which reflect the planned program integrity portal and the new data required in the proposed regulation.

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Annual Cost to Federal Government: $1,000,000

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: 02/21/2020

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