3. ICRs Regarding State Plan Amendment (SPA) Submissions To Implement and Confirm Compliance (§ 430.10)

The following changes will be submitted to OMB for approval under control number 0938-1188 (CMS-10434 #15).

Section 1902(a) of the Act requires that States have a State plan for medical assistance that meets certain Federal requirements that set forth a framework for the State program. States will be required to submit a SPA (and any associated attachments) using a new, CMS-provided template to implement the community engagement requirement consistent with section 1902(xx) and CMS implementing regulations at § 430.10.

SPA submissions will describe State policies and operational approaches, including notices, exceptions, exclusions, and compliance procedures, and will be updated as needed when State approaches change. As noted in section H.2. of this IFC, States must specify the number of consecutive months an applicable individual must demonstrate community engagement prior to the month of application in the State plan.

To develop the SPA, States will need to describe the process they are using to implement community engagement standards, including the processes to confirm and document an applicant's or beneficiary's compliance with the community engagement requirement.

We estimate that it will take approximately 44 hours per jurisdiction for this one-time activity. States will have to document their processes, identify and compile all necessary information, and amend their State Plans. Of the 44 hours, we estimate that it will take 40 hours at $87.52/hr for a Business Operations Specialist to prepare and submit the SPA and 4 hours at $128.00/hr for a General and Operations Manager to review the data and submit the SPA. In aggregate, we estimate a one-time burden of 1,936 hours (44 hr × 44 jurisdictions) at a cost of $176,563 ((44 jurisdictions × (40 hr × $87.52/hr) + (4 hr × $128.00/hr)). Accounting for the Federal administrative match of 50 percent, we estimate a State cost of $88,282 ($176,563 × 0.50). We have summarized the total burden in Table 9.