Reconciliation Tool for the Teaching Health Centers Graduate Medical Education Program

Forms and Documents

Document Name	Status
Form 1 Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program Form	Modified
Supporting Statement.doc Supporting Statement A	2014-05-28
Reconciliation_Tool_Instructions 052611.docx Supplementary Document	2011-06-02

IC Document Collections

IC ID	Document Title	Status
197986	Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program Form	Modified

ICR Details

OMB Control No: 0915-0342	ICR Reference No: 201404-0915-002
Status: Historical Active	Previous ICR Reference No: 201106-0915-001
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Reconciliation Tool for the Teaching Health Centers Graduate Medical Education Program
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: 06/03/2014
	Date Received in OIRA: 04/23/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2017	36 Months From Approved	08/31/2014
Responses	44	0	51
Time Burden (Hours)	88	0	255
Cost Burden (Dollars)	0	0	0

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Abstract: The Teaching Health Center Graduate Medical Education (THCGME) program statute provides that eligible Teaching Health Centers receive payments for both direct and indirect costs associated with training residents in community-based ambulatory patient care centers. THCGME payments are prospective payments and the statute provides for a reconciliation process, through which overpayments may be recouped and underpayments may be adjusted at the end of the fiscal year. This data collection instrument will gather information relating to the numbers of residents in THCGME training programs in order to reconcile payments for both direct and indirect costs. The likely responders to the THCGME Reconciliation Tool are existing THCGME awardees.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 5508 Name of Law: Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 4475	01/28/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 18037	03/31/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program	1	Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program

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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	44	51	0	-7	0	0
Annual Time Burden (Hours)	88	255	0	-167	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The initial request was developed during the first year of the program. The original number of respondents was based on projected program growth. The number of respondents has been adjusted to reflect the actual number of THCGME programs. The Reconciliation Tool has been utilized by THC awardees for three cycles and takes less time to complete than projected at the start of the program. A column requesting the date of an absence was added to the tool. There are two THCGME payments each fiscal year. One payment covers three months of training and the other payment covers nine months of training. Identifying the point within the fiscal year that an absence in training occurred ensures an accurate recoupment amount.

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Annual Cost to Federal Government: $8,903

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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? Uncollected

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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: 04/23/2014

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