GenIC#16 Qualitative Testing of Creative Materials for Medicare

Generic Social Marketing & Consumer Testing Research (CMS-10437)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1247 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10437.GenIC#16 GenIC#16 Qualitative Testing of Creative Materials for Medicare Form and Instruction
CMS-10437.GenIC#16 GenIC#16 - MedicareCreativeTesting_FGguide_FINAL.docx CMS-10437.GenIC#16 - MedicareCreativeTesting_FGguide_FINAL.docx Form and Instruction
CMS-10437.GenIC#16 - Justification for Providing Incentives for Participation in Marketing Research-revised-1-30-18 (final).docx GenIC#16 - Justification for Providing Incentives for Participation in Marketing Research IC Document
CMS-10437.GenIC#16 - MedicareCreativeTesting_SupportingStatement_revised 1-30-18 (final).docx GenIC#16 - MedicareCreativeTesting_SupportingStatement IC Document
CMS-10437.GenIC#16 - QualTestingCreativeMats_CoverPage_FINAL.docx CMS-10437.GenIC#16 - QualTestingCreativeMats_CoverPage IC Document

Information Collection (IC) Details

IC Title:	GenIC#16 Qualitative Testing of Creative Materials for Medicare	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10437.GenIC#16	GenIC#16 - MedicareCreativeTesting_FGguide_FINAL.docx	CMS-10437.GenIC#16 - MedicareCreativeTesting_FGguide_FINAL.docx		Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	1,500	1,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC#16 - Justification for Providing Incentives for Participation in Marketing Research	CMS-10437.GenIC#16 - Justification for Providing Incentives for Participation in Marketing Research-revised-1-30-18 (final).docx	02/15/2018
GenIC#16 - MedicareCreativeTesting_SupportingStatement	CMS-10437.GenIC#16 - MedicareCreativeTesting_SupportingStatement_revised 1-30-18 (final).docx	02/15/2018
CMS-10437.GenIC#16 - QualTestingCreativeMats_CoverPage	CMS-10437.GenIC#16 - QualTestingCreativeMats_CoverPage_FINAL.docx	02/15/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.