Supporting Statement A - MAC Satisfaction Indicator Participant Registry REV 12-28-12 [rev 4-4-13 by OSORA PRA]

Supporting Statement – Part A

MAC Satisfaction Indicator (MSI) Participant Information

Registration Form

Background

Section 1874(A)(b)(3)(B) of the Social Security Act requires that provider satisfaction be a performance standard for the work of Medicare Administrative Contractors (MACs).

To administer the MAC Satisfaction Indicator (MSI) to the Medicare provider community and improve the response rates, CMS will create a registry of potential MSI participants by soliciting volunteers. To accomplish this effort, CMS is seeking to collect accurate contact information from providers using the MSI Participant Information Registration form and furnish the MSI team with an electronic file from which to draw the MSI sample. The objective will be to obtain a sufficient sample population to measure the performance of each MAC while maximizing the response rate. This form is not a survey. The purpose of the form again, is to collect accurate provider contact information for administering the survey.

The MAC Satisfaction Indicator (MSI) is a survey instrument that will be administered annually to measure provider satisfaction with the MACs from which they receive services. The survey is being processed separately from the MSI Participant Information Registration form via contractor and Interagency Agreement. Thus, the survey will not be added to this package and that it will be processed under a different control number from that of the MSI Participant Information Registration form via an Interagency Agreement (between January 2, 2013 and February 28, 2013). The MSI will provide CMS the ability to measure MAC performance in accordance with the Social Security Act noted above. To accomplish this goal, CMS need to be able to contact potential respondents in the provider community. Collecting provider contact information via the developed MSI Participant Information Registration form from those who volunteer to participate will help us reach that goal. We are expecting the MSI Participant Information Registration to be published in the Federal Register on or about January 18, 2013.

A. Justification

1 . Need and Legal Basis

Section 1874(A)(b)(3)(B) of the Social Security Act requires that provider satisfaction be a performance standard for the work of Medicare Administrative Contractors (MACs). In order to gain provider feedback regarding their satisfaction with their MACs, we need to be able to contact the providers. Therefore, we need accurate contact information to select from for a random sample, get the survey to the appropriate respondent and increase response rates.

Also, all customer information received by CMS shall be handled in accordance with the Privacy Act of 1974. The files will be kept confidential and will only be used for purposes of the MSI outlined herein.

2. Information Users

CMS is requesting approval of the MSI Participant Information Registration form and information collection process. This is a 508-compliant, online, fillable form for collecting provider contact information to use for each administration of the MSI. CMS will not be housing a system of records nor will any personally identifiable information be disseminated. The contact information collected will create a contact list for sample selection. The information collected will include, but is not limited to, the following:

1. Participant’s name

2. Participant’s job category

3. Provider’s individual National Provider Identifier (NPI)

4. Provider Transaction Access Number (PTAN)

5. State associated with NPI (drop-down option)

6. Participant’s email address

7. MAC associated with NPI (drop-down option)

8. Enrollment type of NPI (drop-down option)

9. Approximate number of Medicare claims submitted annually (drop-down option)

10. Preference for being signed up to the CMS electronic mailing list (yes/no options)

The request to provide information is strictly voluntary. It will take the participant approximately 1 minute to complete the MSI Participant Registration Information form.

3. Use of Information Technology

CMS will use a 508-compliant fillable form for providers and their representatives to voluntarily submit contact information. A link to this form will be made available through CMS provider electronic mailing lists and the CMS website.

The information submitted through this fillable form will populate a registry. This registry will be used to pull the random sample for the annual administration of the MAC Satisfaction Indicator. Once the sample is determined, it will be encrypted and sent to the MSI contractor.

The information submitted through this fillable form will populate a registry. This registry will be used to pull the random sample for the annual administration of the MAC Satisfaction Indicator. Once the sample is determined, it will be encrypted and sent to the MSI contractor.

Maintenance on the collection form includes review, edits and possible updates of the content. CMS reserves the right to update the form as follows:

- revise drop down options;

- add and/or change item categories, answer options and form features to capture the most up-to-date information in the dynamic MAC and provider communities; and

- add up to a maximum of 3 data fields.

CMS will maintain all registrant information for one MAC Satisfaction Indicator (MSI) administration (1 year). At the end of each annual administration, CMS will discard the prior year’s registrations and begin a new participant registration for the next MSI administration. Prior to each MSI registration, CMS will contact the previous year’s registrants via their email address and ask them if they would like to participate in the next administration of the MSI. Both previous registrants interested in continuing their participation and new Medicare provider registrants will be asked to register for the next MSI administration by going to the web link provided to complete and submit the form.

*To comply with the Government Paperwork Elimination Act (GPEA), you must also include the following information in this section:

- Is this collection currently available for completion electronically? Yes.

- Does this collection require a signature from the respondent(s)? No.

- If CMS had the capability of accepting electronic signature(s), could this collection be made available electronically? This collection is an electronic collection, no signatures required.

- If this collection isn’t currently electronic but will be made electronic in the future, please give a date (month & year) as to when this will be available electronically and explain why it can’t be done sooner. N/A

- If this collection cannot be made electronic or if it isn’t cost beneficial to make it electronic, please explain. N/A

4. Duplication of Efforts

There is no duplication of efforts. With former provider satisfaction surveys, the data files that were used to collect provider contact information to draw the survey sample such as, PECOS, NSC, STAR and OSCAR. These data files were found to contain no provider email addresses and outdated mailing addresses and telephone numbers. Provider information changes frequently, and data that is more than a year old tends to be inaccurate. The information contained in the forementioned data files are not updated regularly. For this reason, we developed the MSI Participant Information Registration form to collect accurate and up-to-date provider contact information, yearly

5. Small Businesses

MSI Participant Information Registration is voluntary. No obligation to participate.

6. Less Frequent Collection

If the MSI collection is conducted less frequently, CMS will not have a reliable resource for collecting and obtaining up-to-date provider contact information and developing the survey sample. Provider information changes frequently, and data that is more than a year old tends to be inaccurate. Without correct contact information, CMS would not be able to administer the survey. Thus, resulting in an inability to measure provider satisfaction and develop a performance standard for the work of Medicare Administrative Contractors (MACs) as required in Section 1874(A)(b)(3)(B) of the Social Security Act.

7. Special Circumstances

For this MSI Participant Information Registration, there are no special circumstances that would require any of the statements listed below:

Explain any special circumstances that would cause an information collection to be conducted in a manner.

- requiring respondents to report information to the agency more often than quarterly;

- requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it;

- requiring respondents to submit more than an original and two copies of any docu­ment;

- requiring respondents to retain records, other than health, medical, government contract, grant-in-aid, or tax records for more than three years;

- in connection with a statistical survey that is not designed to produce valid and reli­able results that can be generalized to the universe of study,

- requiring the use of a statistical data classi­fication that has not been reviewed and approved by OMB;

- that includes a pledge of confidentiality that is not supported by authority estab­lished in statue or regulation that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or

- requiring respondents to submit propri­etary trade secret, or other confidential information unless the agency can demon­strate that it has instituted procedures to protect die information's confidentiality to the extent permitted by law.

8. Federal Register/Outside Consultation

The 60-day Federal Register notice published on January 8, 2013 (78 FR 1212). One comment was received and our response has been added to this PRA package.

N/A – There has been no outside consultation regarding the MSI Registration form.

9. Payments/Gifts to Respondents

N/A - There will be no payment or gifts offered to respondents.

10. Confidentiality

The CMS MSI Team has consulted with representatives of the CMS Privacy Office regarding privacy policies on securing personally identifiable information. All customer information received by CMS shall be handled in accordance with the Privacy Act of 1974. The files will be kept confidential and will only be used for purposes of the MSI outlined herein.

11. Sensitive Questions

N/A – There are no sensitive questions asked on the MSI Participant Information Registration form.

12. Burden Estimates (Hours & Wages)

The request to provide information is strictly voluntary. It will take the participant approximately 1 minute to complete the MSI Participant Information Registration form. The total number of respondents anticipated is 150,000 and 100,000 small entity or 2,500 hr (total). All responses will be collected electronically. The affected public will be the private sector, businesses and other for-profits and non-for-profit institutions. There is no additional cost to Federal Government because the labor will be performed by CMS employees.

13. Capital Costs

N/A – There is no cost burden to respondents.

14. Cost to Federal Government

There is no additional cost to Federal Government because the labor will be performed by CMS employees.

15. Changes to Burden

N/A – There are no changes to burden. This is a new collection.

16. Publication/Tabulation Dates

N/A – No MSI Participant Information Registry results will be publicized.

17. Expiration Date

CMS will be using the MSI Participant Information Registration form on an annual basis for the next 3 years and would like to display the expiration date on the form.

18. Certification Statement

There are no exceptions to the certification statement.

B. Collections of Information Employing Statistical Methods

This collection does not employ any statistical methods.

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