Medicare Advantage and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Non_responseChapter2008TechSHORT.docx	Supplementary Document	Uploaded 2010-10-27	Available
Case-mix adjustment .docx	Supplementary Document	Uploaded 2010-10-27	Available
REV_ MA FFS PDP CAHPS OMB SUPPORTING STATEMENT A 10_25_2010 .doc	Supplementary Document	Uploaded 2010-10-27	Available
2010 CAHPS OMB SUPPORTING STATEMENT PART B .doc	Supporting Statement B	Uploaded 2010-07-30	Available
ATTACHMENT 1 Pre-Note and Cover Letters.docx	Supplementary Document	Uploaded 2010-07-30	Repair queued
REV - RESPONSE_CMS-R-246_PBP_60_Day_Comments_06302010_.docx	Supplementary Document	Uploaded 2010-07-30	Available
REV1 MA_FFS_PDP_CAHPS_OMB_SUPPORTING_STATEMENT_A_Only_10_26_10.doc	Supporting Statement A	Uploaded 2010-10-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8404	Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: MA Survey (CMS-R-246)	Other-MA Survey Crosswalk	Modified
194258	Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: Stand Alone PDP Survey (CMS-R-246)	Other-Stand Alone PDP Survey	New
194257	Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: Medicare FFS Survey (CMS-R-246)	Other-Medicare FFS Survey Crosswalk	New
194256	Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: MA & PDP Plan Burden	Other-MA-PDP Survey Crosswalk	New

ICR Details

OMB Control No: 0938-0732	ICR Reference No: 201008-0938-008
Status: Historical Active	Previous ICR Reference No: 200706-0938-005
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare Advantage and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey
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: 10/29/2010
	Date Received in OIRA: 08/13/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2013	36 Months From Approved	11/30/2010
Responses	567,324	0	660,000
Time Burden (Hours)	242,376	0	217,800
Cost Burden (Dollars)	3,120,000	0	0

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Abstract: CMS has fielded the MA (Consumer Assessment of Health Care Providers and Systems) CAHPS Survey annually since 1998, the Medicare FFS CAHPS Survey annually since 2000, and the MA DP and Stand Alone PDP CAHPS survey annually since 2006. The Medicare CAHPS is a national survey of health and prescription drug plans conducted at the contract level for MA, MA PD and Stand Alone PDP plans and at the state level for Medicare fee-for-service. Medicare CAHPS provides data to permit preparation of plan performance measures to assist Medicare beneficiaries in their selection of a health and/or prescription drug plan and help policymakers and others assist the Medicare program and Medicare plans design and monitor patient-centered quality improvement initiatives. The 2009 Call letter for MA and MA PD plans requires these plans to contract with private vendors from a list selected by CMS to conduct the 2011 Medicare CAHPS survey for their plan at the contract level and provide the collected data to CMS for analyses and preparation of CAHPS measures for use in consumer and plan reports and for quality improvement purposes for MA, MA PD, and Stand Alone PDP plans. CMS will continue to collect the Medicare FFS CAHPS data from surveys at the state and some sub-state levels.

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Authorizing Statute(s): PL: Pub.L. 108 - 173 1860D Name of Law: Information to Facilitate Enrollment
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AP77	Final or interim final rulemaking	75 FR 19760	04/15/2010

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 20365	04/19/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 43168	07/23/2010
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: MA Survey (CMS-R-246)
Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: MA & PDP Plan Burden
Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: Medicare FFS Survey (CMS-R-246)
Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: Stand Alone PDP Survey (CMS-R-246)

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ICR Summary of Burden

table that charts list 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	567,324	660,000	0	-92,676	0	0
Annual Time Burden (Hours)	242,376	217,800	0	24,576	0	0
Annual Cost Burden (Dollars)	3,120,000	0	0	3,120,000	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The burden of this requirement is the time and effort necessary for sample members to complete the CAHPS Survey. The average time to complete the CAHPS survey remains about 20 minutes. This time varies somewhat by survey type as sample members are asked questions related to the type of health or prescription drug plan for which they were sampled. Sample members in Medicare plans without prescription drug benefits are not asked questions about their prescription drug experiences and those enrolled in PDPs are not asked questions about their health care experiences. The total survey burden to all 566,700 sampled beneficiaries therefore for is 208,680 hours, virtually the same number of burden hours that OMB approved for the CAHPS survey in 2007.

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Annual Cost to Federal Government: $4,500,000

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]? No

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: 08/13/2010

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