1. ICRs Regarding State Requirements To Submit Data for Monitoring Community Engagement (§ 435.562)

The following changes will be submitted to OMB for approval under control numbers 0938-1148 (CMS-10398 #35), 0938-1188 (CMS-10434 #66), and 0938-0345 (CMS-R-284).

Sections 1902(a)(6) and (a)(75) of the Act provide CMS with the authority to require States to submit data that allows CMS to monitor State eligibility and enrollment processes. Under these existing statutory authorities, States submit monthly Medicaid and CHIP eligibility and enrollment information to CMS through the Medicaid and CHIP Performance Indicator data via CMS-10398 #35, the Medicaid and CHIP Eligibility Processing data via CMS-10434 #66, and T-MSIS data submissions via CMS-R-284. These established data collections support program transparency and oversight by enabling CMS, States, and the public to monitor eligibility and enrollment operations and by allowing CMS to identify potential compliance and program integrity concerns and to initiate timely engagement with State agencies.

As discussed in section II.O. of this IFC preamble and codified at § 435.562, CMS will require State submissions of monitoring and program operations data related to community engagement implementation and outcomes according to the cadence and not later than the deadline specified by us, including (as applicable) reporting through existing Medicaid data systems identified above and below in Table 5. Under CMS-10398 #35, CMS-10434 #66, and CMS-R-284, States must submit data for the following data elements for applicants and beneficiaries applying for and receiving medical assistance, including individuals subject to the requirements of section 1902(xx) of the Act or § 435.562, or must make system and reporting changes to enable the collection of these data elements:

Enrollment totals of individuals applying for and receiving medical assistance.

Application and renewal processing timeliness, and backlogs.

Outcomes determinations and redeterminations of eligibility.

Population counts of individuals subject to and their compliance with the requirements of section 1902(xx) of the Act (or §§ 435.550 through 435.563).

Any other data specified by CMS to monitor State implementation of §§ 435.550 through 435.563.

For reporting community engagement monitoring data, a State is defined as any of the 50 States and the District of Columbia that provides medical assistance that is subject to the requirements at section 1902(xx) of the Act. We estimate that 44 jurisdictions meet this definition (43 States and the District of Columbia) and that they will need to assess their inputs and develop the necessary data outputs for submission to CMS to support compliance with the community engagement reporting requirements. For the purpose of estimating burden, we assume these jurisdictions will need to submit the community engagement data to CMS monthly. However, CMS may specify a different, less frequent cadence, at a later date.