Information Collection Request

Medicare Current Beneficiary Survey (MCBS)

ICR 201008-0938-025 · OMB 0938-0568 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form CMS-P-0015A Medicare Current Beneficiary Survey (MCBS): Rounds 48-56 (CMS Number CMS-P-0015A) Form and Instruction Removed Repair queued
UPDAttachments TOC.docx Supplementary Document Uploaded 2010-12-17 Available
Attachment 3 - UPDMCBSBrochure.pdf Supplementary Document Uploaded 2010-12-17 Available
Attachment 3 - UPDAttheDoorBrochure2010.pdf Supplementary Document Uploaded 2010-12-17 Available
Attachment 12 - SOR.MCBS.FED.REG.2006.pdf Supplementary Document Uploaded 2010-12-17 Available
CMS Response.docx Supplementary Document Uploaded 2010-12-17 Available
SupportingStatementPartB.pdf Supporting Statement B Uploaded 2010-08-25 Available
04-MCBS Confidentiality Agreement.pdf Supplementary Document Uploaded 2007-02-09 Available
04-MCBS Brochure.pdf Supplementary Document Uploaded 2007-02-09 Available
04-MCBS At the Door Sheet.pdf Supplementary Document Uploaded 2007-02-09 Available
04-CMS Advance Letter with letterhead.pdf Supplementary Document Uploaded 2007-02-09 Available
06-2007 Continuing.pdf Supplementary Document Uploaded 2007-02-09 Repair queued
06-2006-2007 Supplemental.pdf Supplementary Document Uploaded 2007-02-09 Repair queued
attachment 06.pdf Supplementary Document Uploaded 2007-02-09 Available
attachment 11.zip Supplementary Document Uploaded 2010-08-25 Repair queued
attachment 10.zip Supplementary Document Uploaded 2010-08-25 Available
attachment 09.zip Supplementary Document Uploaded 2010-08-25 Available
attachment 08.zip Supplementary Document Uploaded 2010-08-25 Available
attachment 07.zip Supplementary Document Uploaded 2010-08-25 Available
Attachments TOC.pdf Supplementary Document Uploaded 2010-08-25 Available
attachment 03.zip Supplementary Document Uploaded 2010-08-25 Repair queued
attachment 02.zip Supplementary Document Uploaded 2010-08-25 Repair queued
attachment 01.zip Supplementary Document Uploaded 2010-08-25 Repair queued
UPDSupportingStatementPartA.docx Supporting Statement A Uploaded 2010-12-17 Available
IC Document Collections
IC IDCollectionTypeStatusForm
8171 Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A) Other-Spanish Version Modified
178995 Medicare Current Beneficiary Survey (MCBS): Rounds 48-56 (CMS Number CMS-P-0015A) Form and Instruction Removed
ICR Details
0938-0568 201008-0938-025
Historical Active 200703-0938-003
HHS/CMS
Medicare Current Beneficiary Survey (MCBS)
Revision of a currently approved collection   No
Regular
Approved with change 12/20/2010
Retrieve Notice of Action (NOA) 08/31/2010
  Inventory as of this Action Requested Previously Approved
12/31/2013 36 Months From Approved 12/31/2010
48,650 0 49,500
57,062 0 50,325
0 0 0

The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a nationally representative sample of aged, disabled, and institutionalized Medicare beneficiaries. MCBS, which is sponsored by the Centers for Medicare & Medicaid Services (CMS), is the only comprehensive source of information on the health status, health care use and expenditures, health insurance coverage, and socioeconomic and demographic characteristics of the entire spectrum of Medicare beneficiaries. The core of the MCBS is a series of interviews with a stratified random sample of the Medicare population, including aged and disabled enrollees, residing in the community or in institutions. Questions are asked about enrollees' patterns of health care use, charges, insurance coverage, and payments over time. Respondents are asked about their sources of health care coverage and payment, their demographic characteristics, their health and work history, and their family living circumstances. In addition to collecting information through the core questionnaire, the MCBS collects information on special topics through supplements. For example, questions are asked about enrollees' income and assets, access to health care, health and functional status and satisfaction with care. Special supplements also focus on emerging trends in health care.

PL: Pub.L. 108 - 173 722(b)(1) Name of Law: Medicare Prescription Drug, Improvement, and Modernization Act
  
None

Not associated with rulemaking

  75 FR 30030 05/28/2010
75 FR 49494 08/13/2010
No

  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 48,650 49,500 0 -850 0 0
Annual Time Burden (Hours) 57,062 50,325 0 6,737 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
The increase in burden hours is a direct result of two separate factors. The first is the computer assisted in-person interviewing (CAPI) operating platform conversion effort. The change in functionality has contributed much of the increase; however, this is not the only reason for the burden increase. The addition of Medicare Part D to the program has increased the number of statements with which must be recorded. In an effort to defray some of this increased burden, several methodological modifications have been adopted. Two primary steps that have been taken to help reduce overall burden are, to change the utilization reference period and changing the facility reference period from every 4 months to every 6 months.

$16,210,970
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Bonnie Harkless 4107865666

  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.
08/31/2010