Supporting Statement or
Medicare Modernization Act Outreach Program
Form SSA-1023
OMB No. 0960-0773
Justification
Introduction/Authoring Laws and Regulations
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), Public Law 108-173, created a voluntary prescription drug benefit program under the new Medicare Part D. The MMA stipulates Medicare beneficiaries who meet income and resource limits are eligible to receive a subsidy for this program. Medicare beneficiaries not automatically enrolled in the subsidy program may apply to the Social Security Administration (SSA) for subsidy consideration using Form SSA-1020 (OMB No. 0960-0696), the Application for Help with Medicare Prescription Drug Plan Costs. Section 20 CFR 418 of the Code of Federal Regulations describe the provisions of the MMA.
To promote awareness of the program and encourage potentially eligible Medicare beneficiaries to complete the SSA-1020, SSA uses the Medicare Modernization Act Outreach Mailer (Form SSA-1023). Section 205 of the Social Security Act gives us the authority to collect this information.
Description of Collection
SSA uses the information we obtain through this collection to identify potentially eligible beneficiaries for the Medicare Part D subsidy and to encourage them to complete and submit the SSA-1020 (OMB No. 0960-0696) subsidy application form. We target the combination mailer/brochure to those who might have missed the initial campaign or who do not understand their potential eligibility for the extra help. We market the brochure to Medicare recipients, as well as their family members, friends, and professional caregivers. Below we describe how we use this brochure and its attached return mailer.
Methodology
The Medicare Modernization Mailer Insert (Form SSA-1023) is on display in various locations around the country, including local and national chain pharmacy counters, doctors’ offices, medical clinics, etc. This display consists of a cardboard foldout brochure advertising Form SSA-1020; the brochure contains the collection instrument, Form SSA-1023, Medicare Modernization Mailer Insert.
Once interested Medicare beneficiaries complete form SSA-1023 and return it to SSA, we scan the contact information from the form and mail a Medicare Part D Subsidy Application (SSA-1020) to the Medicare beneficiary. When the beneficiary returns the completed SSA-1020 to SSA, the agency can then determine eligibility for a subsidy.
If beneficiaries do not return a completed SSA-1020, SSA contacts them via a recorded automated telephone call to remind them about the form and encourage them to complete and return it. We conduct the outreach telephone calls across the nation during normal business hours. We make the automated calls 45 days after we mail the SSA-1020. When necessary, MRS makes two attempts to contact the beneficiaries, once in the morning and again in the evening of the same day. We use the same automated message for both attempts. Please see the attached supplementary document, “MMA Outreach Phone Message,” for the exact text of this message.
NOTE: The telephone call consists of a recorded message from the Medicare Automated Reminder System (MRS); there is no actual discussion with an SSA employee. Because the call does not impose any burden, it is PRA-exempt and we are not seeking OMB clearance for it in this ICR. This clearance package only covers the return mailer, form SSA-1023.
Use of Information Technology to Collect the Information
The nature of this mailer is such that the requirements of the Government Paperwork Elimination Act do not apply, so there is no electronic version of this collection. However, respondents can complete and submit the actual SSA-1020 electronically.
Why We Cannot Use Duplicate Information
The nature of the information we are collecting and the manner in which we are collecting it preclude duplication. SSA does not use another collection instrument to obtain similar data.
Minimizing Burden on Small Respondents
This collection does not affect small businesses or other small entities.
Consequence of Not Collecting Information or Collecting it Less Frequently
If SSA did not conduct this ongoing collection, we would lose a valuable means of reaching and encouraging many potentially eligible Medicare Part D beneficiaries to apply for the subsidy. Since we are only collecting the information once, we cannot collect it less frequently.
There are no technical or legal obstacles to burden reduction.
Special Circumstances
There are no special circumstances that would cause SSA to collect this information collection in a manner inconsistent with 5 CFR 1320.5.
Solicitation of Public Comment and Other Consultations with the Public
SSA published the 60-day advance Federal Register Notice on February 14, 2011 at 76 FR 8394 and we received no public comment. We published the 30-day Notice on April 27, 2011 at 76 FR 23640. If we receive any comments from the 30-day Notice, we will forward them to OMB. We have had no consultations with members of the public.
Payment or Gifts to Respondents
SSA provides no payment or gifts to the respondents.
Assurances of Confidentiality
SSA protects and holds confidential the information requested in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A-130.
Justification for Sensitive Questions
This information collection does not contain any questions of a sensitive nature.
Estimates of Public Reporting Burden
Approximately 75,000 respondents spend 1 minute each completing Form SSA-1023 annually. According, the total burden is 1,250 hours. The total burden reflects burden hours, and we did not calculate a separate cost burden.
Annual Cost to the Respondents (Other)
There is no known cost burden to the respondents.
Annual Cost To Federal Government
The cost estimate for printing and distributing Form SSA-1023 is $180,348.00.
Program Changes or Adjustments to the Information Collection Request
The decrease in the public reporting burden is due to our removing the automated follow-up telephone call as part of the public reporting burden. This is a telephone call with a pre-recorded, automated message played to respondents. We should not have reported this activity as having burden when we last cleared this ICR. There is no public reporting burden associated with this activity.
Plans for Publication Information Collection Results
SSA will not publish the results of the information collection.
Displaying the OMB Approval Expiration Date
OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms, with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms, (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.
Exceptions to Certification Statement
SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).
Collections of Information Employing Statistical Methods
We do not use statistical methods for this information collection.
SSA-1023 (OMB No. 0960-0773)
Supporting Statement
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | SUPPORTING STATEMENT FOR |
| Author | 572868 |
| File Modified | 0000-00-00 |
| File Created | 2021-02-01 |