Evaluation of Five State Health Care Reform Demonstrations and the Evaluation of the Medicaid State Health Reform

Forms and Documents

Document	Type	Status	Availability

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Collection	Type	Status	Form
8348	Evaluation of Five State Health Care Reform Demonstrations and the Evaluation of the Medicaid State Health Reform	Form	Migrated

ICR Details

OMB Control No: 0938-0708	ICR Reference No: 199709-0938-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Evaluation of Five State Health Care Reform Demonstrations and the Evaluation of the Medicaid State Health Reform
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/07/1997
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/08/1997
Terms of Clearance: This information collection is approved through 11-2000 as revised by the 11-5-97 HCFA memo and under the following conditions: As agreed to by HCFA, the findings in these evaluations are limited to "lessons learned" in each State. In the evaluations in NY, MN and IL, HCFA may make claims about the effects of managed care on access, cost satisfaction etc, in those particular States. In all other States, the findings are limited to identifying differences in outcomes across types of managed care plans. The research in these States will not produce impact information, but will supplement the body of information on types of managed care, from which HCFA will be able to form hypotheses that may be tested at a later date.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2000	11/30/2000
Responses	34,035	0	0
Time Burden (Hours)	10,279	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: These evaluations will investigate health care reform in ten States that will implement or have implemented demonstration programs using section 1115 waivers. The surveys will gather information to answer questions regarding access to health care, quality of care delivered, satisfaction with health services, and the use and cost of health services. The surveys will be administered to Medicaid eligible and newly covered enrollees and eligible and near-eligible non-enrollees. A subsample of survey respondents will be SSI recipients and other disabled people who have participated in demonstrations.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Evaluation of Five State Health Care Reform Demonstrations and the Evaluation of the Medicaid State Health Reform	HCFA-R-207

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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	34,035	0	0	34,035	0	0
Annual Time Burden (Hours)	10,279	0	0	10,279	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

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: 09/08/1997

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