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
Form CMS-R-246 Medicare Advantage Only - Survey	Form and Instruction	Modified	Available
Form CMS-R-246 Stand Alone PDP Survey	Form and Instruction	Modified	Available
Form CMS-R-246 Medicare FFS Survey	Form and Instruction	Modified	Available
Form CMS-R-246 MA-PDP Survey	Form and Instruction	Modified	Available
CMS-R-246_REVISED_Supporting_Statement_Parts_B.pdf	Supporting Statement B	Uploaded 2011-09-26	Available
CMS-R-246 MA FFS PDP CAHPS OMB SUPPORTING STATEMENT A B 2 09 12 clean.doc	Supporting Statement A	Uploaded 2012-04-18	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)	Form and Instruction	Modified	Medicare Advantage Only - Survey
194258	Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: Stand Alone PDP Survey (CMS-R-246)	Form and Instruction	Modified	Stand Alone PDP Survey
194257	Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: Medicare FFS Survey (CMS-R-246)	Form and Instruction	Modified	Medicare FFS Survey
194256	Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: MA & PDP Plan Burden	Form and Instruction	Modified	MA-PDP Survey

ICR Details

OMB Control No: 0938-0732	ICR Reference No: 201110-0938-001
Status: Historical Active	Previous ICR Reference No: 201008-0938-008
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: 06/01/2012
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/04/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2015	36 Months From Approved	10/31/2013
Responses	598,809	0	567,324
Time Burden (Hours)	249,441	0	242,376
Cost Burden (Dollars)	3,045,000	0	3,120,000

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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. This revision to a currently approved collection is to add questions focusing on care coordination. The Medicare CAHPS survey has taken the OMB No. 0935-0732.

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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:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 31338	05/31/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 57745	09/16/2011
Did the Agency receive public comments on this ICR? No

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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 & PDP Plan Burden	CMS-R-246	MA-PDP Survey
Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: MA Survey (CMS-R-246)	CMS-R-246	Medicare Advantage Only - Survey
Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: Medicare FFS Survey (CMS-R-246)	CMS-R-246	Medicare FFS Survey
Medicare Advantage and Medicare Fee-For-Service CAHPS Survey: Stand Alone PDP Survey (CMS-R-246)	CMS-R-246	Stand Alone PDP Survey

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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	598,809	567,324	0	31,485	0	0
Annual Time Burden (Hours)	249,441	242,376	0	7,065	0	0
Annual Cost Burden (Dollars)	3,045,000	3,120,000	0	-75,000	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: On average, the burden to Medicare beneficiaries has not changed to complete a CAHPS survey: MA burden is .4 hour and the stand-alone PDP and FFS survey burdens are .25 and .3 hours, respectively. The number of respondents has gone up by approximately 31,500 respondents, and the number of contracts has gone down by approximately 15, so the total survey burden has increased by approximately 7,875 hours. The burden to MA and PDP contracts is 54 hours each, or a total of 32,886 hours across the 609 plans; this is a decrease of approximately 810 hours.

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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: 10/04/2011

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