Survey of Newly Eligible Medicare Beneficiaries

ICR 200205-0938-006

OMB: 0938-0869

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
8686 Migrated
ICR Details
0938-0869 200205-0938-006
Historical Active
HHS/CMS
Survey of Newly Eligible Medicare Beneficiaries
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/03/2002
Retrieve Notice of Action (NOA) 05/03/2002
  Inventory as of this Action Requested Previously Approved
01/31/2003 01/31/2003
3,600 0 0
1,080 0 0
0 0 0

It is not enough to merely mail information about the Medicare program to each beneficiary. We need to know not only that the beneficiaries got the information, but that they understood the information and are able to use it in making choices about their Medicare participation. To this end, CMS must have measure(s) over time of what beneficaries know and understand about the Medicare program now to be able to quantify and attribute any changes to their understanding or behavior to information/ education initiatives. Measuring beneficiary information needs and knowledge over time will help us to evaluate the impact of...

None
None


No

1
IC Title Form No. Form Name
Survey of Newly Eligible Medicare Beneficiaries CMS-10050

  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 3,600 0 0 3,600 0 0
Annual Time Burden (Hours) 1,080 0 0 1,080 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
05/03/2002


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