Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for the Merit-Based Incentive Payment System (MIPS) (CMS-10450)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10450 Appendix H: Vendor Attestation	Form and Instruction	New	Repair queued
Form CMS-10450 Appendix G: Vendor Renewal Form	Form and Instruction	New	Available
Form CMS-10450 Appendix F: Vendor Form	Form and Instruction	New	Available
Form CMS-10450 Appendix E: CATI Script	Form and Instruction	Modified	Available
Form CMS-10450 Attachment B: Mail Survey	Form	Modified	Available
Appendix_J_ Stucky et al. Possibilities for shortening the CAHPS clinician and group survey.pdf	Supplementary Document	Uploaded 2017-08-01	Available
CAHPS for MIPS Supporting Statement Part B clean 7.12.2017.docx	Supporting Statement B	Uploaded 2017-08-01	Available
CAHPS for MIPS Supporting Statement Part A 7.14.2017.docx	Supporting Statement A	Uploaded 2017-08-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
227777	CAHPS for MIPS Group Registration	Instruction	New
227776	CAHPS for MIPS Survey Vendor Application	Form and Instruction	New	Appendix H: Vendor Attestation
227776	CAHPS for MIPS Survey Vendor Application	Form and Instruction	New	Appendix G: Vendor Renewal Form
227776	CAHPS for MIPS Survey Vendor Application	Form and Instruction	New	Appendix F: Vendor Form
206234	CAHPS for MIPS Survey Beneficiary Participation	Form and Instruction	Modified	Appendix E: CATI Script
206234	CAHPS for MIPS Survey Beneficiary Participation	Form	Modified	Attachment B: Mail Survey
206234	CAHPS for MIPS Survey Beneficiary Participation	Instruction	Modified

ICR Details

OMB Control No: 0938-1222	ICR Reference No: 201708-0938-001
Status: Historical Inactive	Previous ICR Reference No: 201611-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: 19180
Title: Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for the Merit-Based Incentive Payment System (MIPS) (CMS-10450)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 11/17/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/01/2017
Terms of Clearance: OMB files this comment in accordance with 5 CFR 1320.11( c ). This OMB action is not an approval to conduct or sponsor an information collection under the Paperwork Reduction Act of 1995. This action has no effect on any current approvals. If OMB has assigned this ICR a new OMB Control Number, the OMB Control Number will not appear in the active inventory. For future submissions of this information collection, reference the OMB Control Number provided. OMB is withholding approval at this time. Prior to publication of the final rule, the agency should provide a summary of any comments related to the information collection and their response, including any changes made to the ICR as a result of comments. In addition, the agency must enter the correct burden estimates.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2020	36 Months From Approved	04/30/2020
Responses	132,307	0	132,307
Time Burden (Hours)	43,661	0	43,661
Cost Burden (Dollars)	0	0	0

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Abstract: CMS is requesting clearance to implement a revised Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for the Merit-based Incentive Payment System (MIPS). Section 1848(q) of the Social Security Act, as amended by section 101 of the Medicare Access and CHIP Reauthorization Act of 2015, authorizes the establishment of the MIPS for eligible clinicians. The CAHPS for MIPS survey counts for one measure towards the MIPS quality performance category, and groups of two or more MIPS eligible clinicians can voluntarily elect to participate in the CAHPS for MIPS survey as one of their six required quality measures as finalized in the CY 2017 Quality Payment Program final rule. The use of a CAHPS survey (including the CAHPS for MIPS survey) would be counted as a high- weighted activity under the improvement activities performance category. We are requesting approval to use a revised, shorter version of the CAHPS for MIPS survey that will maintain or improve reliability while reducing beneficiary burden.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 10331 Name of Law: Affordable Care Act
   US Code: 42 USC 1395w-4 Name of Law: MACRA of 2015
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 10331 Name of Law: Affordable Care Act
US Code: 42 USC 1395w-4 Name of Law: MACRA of 2015

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT13	Proposed rulemaking	82 FR 30010	06/30/2017

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
CAHPS for MIPS Group Registration
CAHPS for MIPS Survey Beneficiary Participation	CMS-10450, CMS-10450	Attachment B: Mail Survey ,   Appendix E: CATI Script
CAHPS for MIPS Survey Vendor Application	CMS-10450, CMS-10450, CMS-10450	Appendix F: Vendor Form ,   Appendix G: Vendor Renewal Form ,   Appendix H: Vendor Attestation

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: As shown in Table 6, the total estimated burden associated with the three information collections submitted for approval as a revision of 0938-1222 is 29,950 hours with total annual burden cost of $768,748. The currently approved burden estimate for the transition year CAHPS for MIPS survey information collection is 43,361 hours with total annual burden cost of $1,014,252. The reduction of 13,771 burden hours and $245,504 total annual burden cost is mainly due to the proposal to use a shorter survey.

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Annual Cost to Federal Government: $2,120,324

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 08/01/2017

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