Award Fee Provider Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Revisions to the 2014 Award Fee Provider Survey.docx	Supplementary Document	Uploaded 2014-09-29	Available
DMDC-recommendation-letter-Tricare-Award-Fee-Provider-Satisfaction-Survey-OMB-Renewal-April-25-2014.pdf	Supplementary Document	Uploaded 2014-04-26	Available
TMA PCLO review of MC Award Survey_Approved_8-1-12.doc	Supplementary Document	Uploaded 2014-04-18	Available
Award Fee Provider Satisfaction_OMB Supporting_Statement_Part_B_Revised_4_29 14.doc	Supporting Statement B	Uploaded 2014-04-29	Available
Award Fee Provider Satisfaction_OMB Supporting_Statement_Part_A_4 28 14.doc	Supporting Statement A	Uploaded 2014-04-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
194123	Award Fee Provider Survey	Other-Survey Instrument	Modified

ICR Details

OMB Control No: 0720-0048	ICR Reference No: 201404-0720-001
Status: Historical Active	Previous ICR Reference No: 201008-0720-002
Agency/Subagency: DOD/DODOASHA	Agency Tracking No:
Title: Award Fee Provider Survey
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: 09/30/2014
	Date Received in OIRA: 04/29/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	36 Months From Approved	09/30/2014
Responses	1,224	0	1,200
Time Burden (Hours)	102	0	100
Cost Burden (Dollars)	2,942	0	0

---

Abstract: This is a telephone survey of civilian network providers that focuses on three basic administrative processes/services business functions provided of claims processing, customer service, and administrative services by the MCSC contractor.

---

Authorizing Statute(s): EO: EO 13571 Name/Subject of EO: Streamlining Service Delivery and Improving Customer Service
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 4336	01/27/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 22807	04/24/2014
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Award Fee Provider Survey

---

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	1,224	1,200	0	0	24	0
Annual Time Burden (Hours)	102	100	0	0	2	0
Annual Cost Burden (Dollars)	2,942	0	0	0	2,942	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: Change is due to minor increase in estimated number of respondents since last submission.

---

Annual Cost to Federal Government: $32,629

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

---

Common Form ICR:  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:

(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: 04/29/2014

---