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-4168-F version 9).docx Supporting Statement A	2020-12-10

IC Document Collections

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

ICR Details

OMB Control No: 0938-0790	ICR Reference No: 202001-0938-012
Status: Active	Previous ICR Reference No: 201702-0938-012
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
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/10/2020
	Date Received in OIRA: 04/30/2020
Terms of Clearance: CMS will continue to consider ways to streamline and clarify packages associated with the PACE program.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2023	36 Months From Approved	12/31/2020
Responses	78,219	0	165
Time Burden (Hours)	73,149	0	71,455
Cost Burden (Dollars)	0	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-AR60	Final or interim final rulemaking	84 FR 25610	06/03/2019

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 54666	08/16/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 25610	06/03/2019
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
State Requirements
Requirements for PACE Entities

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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	78,219	165	0	78,054	0	0
Annual Time Burden (Hours)	73,149	71,455	0	1,694	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: In this revised PRA package, we are incorporating changes made to PACE as a result of the final PACE Rule, CMS-4168-F, published June 3, 2019, which updates the requirements for PACE under the Medicare and Medicaid programs. The rule addresses application and waiver procedures, sanctions, enforcement actions and termination, administrative requirements, PACE services, participant rights, quality assessment and performance improvement, participant enrollment and disenrollment, payment, federal and state monitoring, data collection, record maintenance, and reporting. The changes will provide greater operational flexibility, remove redundancies and outdated information, and codify existing practice. Based on the final pace rule as well as updated assumptions on wages, the number of POs and several other factors, this PRA package reduces hour burden from the active document by 659 (73,149 hours vs. the former 72,490 hours) and increases costs by $119,402 ($4,168,160 vs. the former 4,287,562).

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Annual Cost to Federal Government: $9,478

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: 04/30/2020

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