Medicare Current Beneficiary Survey (MCBS)

ICR 201702-0938-022

OMB: 0938-0568

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Unchanged
Supplementary Document
2017-02-27
Supplementary Document
2017-02-27
Supplementary Document
2017-02-27
Supplementary Document
2017-02-27
Supplementary Document
2017-02-27
Supplementary Document
2017-02-27
Supplementary Document
2017-02-27
Justification for No Material/Nonsubstantive Change
2017-02-27
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-06-22
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supplementary Document
2016-05-06
Supporting Statement B
2016-06-22
Supporting Statement A
2016-06-22
IC Document Collections
ICR Details
0938-0568 201702-0938-022
Historical Active 201605-0938-004
HHS/CMS 20757 (OEDA)
Medicare Current Beneficiary Survey (MCBS)
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved with change 04/17/2017
Retrieve Notice of Action (NOA) 02/27/2017
  Inventory as of this Action Requested Previously Approved
06/30/2019 06/30/2019 06/30/2019
49,650 0 49,650
60,103 0 60,103
0 0 0

The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a nationally representative sample of aged, disabled, and institutionalized Medicare beneficiaries. MCBS, which is sponsored by the Centers for Medicare & Medicaid Services (CMS), is the only comprehensive source of information on the health status, health care use and expenditures, health insurance coverage, and socioeconomic and demographic characteristics of the entire spectrum of Medicare beneficiaries.

PL: Pub.L. 108 - 173 723 Name of Law: Medicare Prescription Drug, Improvement, and Modernization Act
   PL: Pub.L. 111 - 148 3021 Name of Law: Affordable Care Act
  
None

Not associated with rulemaking

  81 FR 9201 02/24/2016
81 FR 26573 04/29/2016
No

1
IC Title Form No. Form Name
Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A) CMS-P-0015A, CMS_P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS ,   MCBS

  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 49,650 49,650 0 0 0 0
Annual Time Burden (Hours) 60,103 60,103 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
There has been a slight increase in the total annual burden estimate. Overall, the ICR has been revised to account for new questions in the survey.

$17,158,000
Yes Part B of Supporting Statement
No
Yes
No
No
Uncollected
William Parham 4107864669

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
02/27/2017


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