CMS Proposes More Data Collection: Comments Welcome, Zzz
Published Date: 3/21/2025
Notice
Summary
The Centers for Medicare & Medicaid Services (CMS) wants your thoughts on their plan to collect some info from the public. They’re asking for comments by May 20, 2025, to make sure the process is clear, useful, and not too much work. This helps CMS do its job better without wasting anyone’s time or money.
Analyzed Economic Effects
3 provisions identified: 2 benefits, 1 costs, 0 mixed.
Cost-reporting burden for managed care plans
Organizations that contract with CMS (including HMOs, Competitive Medical Plans, and Health Care Prepayment Plans) must submit cost and statistical reports so they can be reimbursed on a reasonable cost basis. The collection uses Form CMS-276 (OMB 0938-0165) and totals 16 respondents, 36 responses, and 1,128 total annual hours.
Mandatory denial notice and appeal info for D-SNP enrollees
Applicable integrated plans must send enrollees a written notice (Form CMS-10716, OMB 0938-1386) when they reduce, stop, suspend, change, or deny a request for a service or payment (including Part B drugs). The rule on integrated organization determinations affects D-SNP administration for January 1, 2021 and beyond; the collection shows 129 respondents, 10,468 responses, and 1,745 total annual hours.
D-SNP enrollee advisory committee data collection
CMS is collecting information about Dual-Eligible Special Needs Plan (D-SNP) enrollee advisory committees as part of the CY 2025 Part C Reporting Requirements using Form CMS-10799 (OMB 0938-1422). The collection lists 398 respondents, 398 responses, and 15,920 total annual hours; MA organizations with D-SNPs would use the information to identify and address barriers to coordinated care.
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Key Dates
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