Healthcare Effectiveness Data and Information Set (HEDIS) Data Collection for Medicare Advantage

Forms and Documents

Document Name	Status
CMS-10219 Supporting Statement Part B (2) 5-10-13.pdf Supporting Statement B	2013-08-27
HEDIS 2013 Volume 5.10.31.12.zip Supplementary Document	2013-08-27
Updated hedis hos cahps 2013_20120801.pdf Supplementary Document	2013-08-27
HEDIS 2013 and HEDIS 2010 Crosswalk for PRA package 8-27-13.docx Supplementary Document	2013-08-27
CMS-10219 - Supporting Statement Part A [rev 8-26-2013 by OSORA PRA].doc Supporting Statement A	2013-08-27

IC Document Collections

IC ID	Document Title	Status
181326	HEDIS Information Collection Request (CMS-10219) Other-HEDIS 2013 Volume 3: Specifications for Survey Measures	Modified

ICR Details

OMB Control No: 0938-1028	ICR Reference No: 201309-0938-001
Status: Historical Active	Previous ICR Reference No: 201009-0938-020
Agency/Subagency: HHS/CMS	Agency Tracking No: 20416
Title: Healthcare Effectiveness Data and Information Set (HEDIS) Data Collection for Medicare Advantage
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/14/2014
	Date Received in OIRA: 09/10/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	36 Months From Approved	02/28/2014
Responses	573	0	483
Time Burden (Hours)	184,320	0	154,560
Cost Burden (Dollars)	0	0	7,245,000

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Abstract: CMS has a responsibility to its Medicare beneficiaries to ensure that care provided by Medicare Advantage (MA) contracts to CMS is of high quality and conforms to currently acceptable standards of medical care. CMS accomplishes this through the collection, analysis and dissemination of HEDIS data, the most widely used standardized clinical performance measurement set in managed care. Since January 1997, Medicare managed care contracts have been required to annually report quality of care performance measures from HEDIS. In April 1997, CMS began working with NCQA to implement HEDIS data collection directly into the Medicare managed care program. It is critical to the agency's mission that CMS continues to collect and disseminate information that will help beneficiaries choose among health plans; information that contributes to better health care through the identification of quality improvement opportunities; and provides for proper oversight and management of the Medicare program. These data are used in external CMS information products issued to beneficiaries, and are published on the CMS public website. These data are also made publicly available through public use files (PUFs) posted on the CMS website. CMS relies heavily on HEDIS data for contractor surveillance and assessment activities. It is critical to the agency's mission that CMS continues to collect and disseminate information that will help beneficiaries choose among health plans; information that contributes to better health care through the identification of quality improvement opportunities; and provides for proper oversight and management of the Medicare program.

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Authorizing Statute(s): US Code: 42 USC Sec. 1395w-22(e)(3)(A) Name of Law: Benefits and beneficiary protections
   PL: Pub.L. 108 - 173 722 (a)(3)(A)(i) Name of Law: MMA
   Statute at Large: 18 Stat. 1852 Name of Statute: null
  

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:
	78 FR 34387	06/07/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 50057	08/16/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
HEDIS Information Collection Request (CMS-10219)

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ICR Summary 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	573	483	0	0	90	0
Annual Time Burden (Hours)	184,320	154,560	0	0	29,760	0
Annual Cost Burden (Dollars)	0	7,245,000	0	0	-7,245,000	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The increased hours and wages are due to the increased number of contracts from 483 plans to 576 contracts. Also, there is increased quality assurance in the HEDIS? data submission and corresponding increase in the labor categories for the contracts for the medical review technologist and a database administrator. The increased quality assurance is because HEDIS? measures are used for the CMS Star Ratings that are publicly reported and for determining the ratings for the Quality Bonus Payments.

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Annual Cost to Federal Government: $325,000

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: 09/10/2013

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