Marketplace Quality Standards (CMS-10520)

Forms and Documents

Document Name	Status
Form CMS-10520 Monitoring and appeals process for survey vendors Form and Instruction	Unchanged
CMS-10520 - Quality Standards Supporting Statement 2016.pdf Supporting Statement A	2016-06-16

IC Document Collections

IC ID	Document Title	Status
212995	Patient safety reporting standards for QHP issuers	Modified
212994	Reporting for the Enrollee Satisfaction Survey (ESS)	Unchanged
212992	Implementation and reporting for the Quality Rating System (QRS)	Unchanged
212011	Monitoring and appeals process for survey vendors Form and Instruction	Unchanged

ICR Details

OMB Control No: 0938-1249	ICR Reference No: 201603-0938-008
Status: Historical Active	Previous ICR Reference No: 201409-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Marketplace Quality Standards (CMS-10520)
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: 08/02/2016
	Date Received in OIRA: 03/10/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2019	36 Months From Approved	09/30/2017
Responses	1,770	0	1,770
Time Burden (Hours)	1,085,095	0	1,084,495
Cost Burden (Dollars)	0	0	0

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Abstract: Section 1311(c)(3) of the Affordable Care Act directs the Secretary to develop a system to rate QHPs on the basis of quality and price and requires Exchanges to display this quality rating information on their respective websites. Section 1311(c)(4) of the Affordable Care Act requires the Secretary to develop an enrollee satisfaction survey (ESS) system to assess enrollee experience with each QHP (with more than 500 enrollees in the previous year) offered through an Exchange. Section 1311(h) requires QHPs to contract with certain hospitals that meet specific patient safety and health care quality standards beginning January 1, 2015. CMS is requesting approval for information collection associated with these related Marketplace quality standards.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1311(c)(3)-(4) Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1311(h) Name of Law: Affordable Care Act
   US Code: 45 USC 156.1110 Name of Law: HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCH
  

Citations for New Statutory Requirements: US Code: 45 USC 156.1110 Name of Law: Establishment of patient safety standards for QHP issuers.

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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:
	80 FR 75488	12/02/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 12204	03/08/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Reporting for the Enrollee Satisfaction Survey (ESS)
Monitoring and appeals process for survey vendors	CMS-10520	Vendor Appeal Form
Implementation and reporting for the Quality Rating System (QRS)
Patient safety reporting standards for QHP issuers

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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	1,770	1,770	0	0	0	0
Annual Time Burden (Hours)	1,085,095	1,084,495	600	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	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 newly established QHP patient safety standards (45 CFR 156.1110) would result in an annual estimated increase of 600 hours (1750-1150 hours) and $68,960 ($157,510-$88,550) for QHP issuers.

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Annual Cost to Federal Government: $901,343

Does this IC contain surveys, censuses, or employ statistical methods? No

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]? Yes

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: 03/10/2016

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