Centenarian Project and Medicare Non-Utilzation Project Development Worksheets: Face-to-Face Interview; Telephone Interview

ICR 201406-0960-010

OMB: 0960-0780

Federal Form Document

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2014-07-14
ICR Details
0960-0780 201406-0960-010
Historical Active 201308-0960-004
SSA
Centenarian Project and Medicare Non-Utilzation Project Development Worksheets: Face-to-Face Interview; Telephone Interview
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 07/23/2014
Retrieve Notice of Action (NOA) 07/15/2014
  Inventory as of this Action Requested Previously Approved
06/30/2016 06/30/2016 06/30/2016
16,000 0 42,000
4,000 0 10,500
0 0 0

SSA conducts interviews with Title XVI recipients age 100 and older, or Title II beneficiaries ages 90 and above who do not use their Medicare benefits for an extended period and who lack private insurance, a health maintenance organization (HMO), or a nursing home (which may indicate the individual is deceased) to: (1) assess if the beneficiaries are still living; (2) to prevent fraud, through either identity misrepresentation or representative payee misuse of funds; and (3) to evaluate the well being of the beneficiaries. SSA field office personnel obtain the information through one-time interviews with these individuals. If the individuals have representatives or caregivers, SSA personnel invite them to the interviews. During the interview, SSA employees make overall observations of the individual and their representative payee (if applicable). The interviewer uses the appropriate Development Worksheet as a guide for the interview, in addition to documenting findings during the interview. Non-completion of the Worksheets, or refusal of the interview, does not result in the suspension of the individual's payments. SSA conducts the interview either over the telephone or through a face-to-face discussion with the individual. This is a national project for our title II beneficiaries and title XVI recipients. Respondents are SSI recipients 100 years old or older; and Social Security beneficiaries ages of 90 and above who are not utilizing their Medicare benefits and lack private insurance, an HMO, or nursing home; their representative payees; or their caregivers. This non-substantive Change Request expands the current program to replace the current Title II Centenarian Project with the Medicare Non-Utilization Project (MNUP), and create a Title XVI only Centenarian Project. See Justification for the Non-Substantive Changes for further information.

US Code: 42 USC 405 Name of Law: The Social Security Act
   US Code: 42 USC 1383 Name of Law: The Social Security Act
  
None

Not associated with rulemaking

  77 FR 76591 12/28/2012
78 FR 17276 03/20/2013
No

2
IC Title Form No. Form Name
Centenarian Project Title XVI Only
Medicare Non-utilization Project (MNUP)

  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 16,000 42,000 0 -21,000 -5,000 0
Annual Time Burden (Hours) 4,000 10,500 0 -5,250 -1,250 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
We requesting to replace the current Title II Centenarian Project with the Medicare Non-Utilization Project, and make the Centenarian Project Title XVI only. We intend to implement this change by September 2014. See Justification for the Non-Substantive Changes for more information.

$185,573
No
No
No
No
No
Uncollected
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
07/15/2014


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