Information Collection

Medicare Current Beneficiary Survey (MCBS): Rounds 20-28

IC 8169 under ICR 199710-0938-007 · OMB 0938-0568.

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Information Collection (IC) Details

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IC Title:	Medicare Current Beneficiary Survey (MCBS): Rounds 20-28	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-P-15A				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	49,500	47,600	1,900
Annual IC Time Burden (Hours)	50,490	34,490	16,000
Annual IC Cost Burden (Dollars)	0	0	0

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Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.