Generic Clearance for Questionnaire Testing and Methodological Research for the Medicare Current Beneficiary Survey (MCBS) (CMS-10549)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-10549_Supporting_Statement_Part_A.docx	Supporting Statement A	Uploaded 2020-12-23	Repair queued
CMS-10549_Supporting_Statement_Part_B.docx	Supporting Statement B	Uploaded 2020-12-22	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
245071	CMS-10549 Gen IC # 1 Testing Revisions to Advance Mailing Materials for the Medicare Current Beneficiary Survey	Instruction	New

ICR Details

OMB Control No: 0938-1275	ICR Reference No: 202012-0938-015
Status: Received in OIRA	Previous ICR Reference No: 202004-0938-011
Agency/Subagency: HHS/CMS	Agency Tracking No: OEDA
Title: Generic Clearance for Questionnaire Testing and Methodological Research for the Medicare Current Beneficiary Survey (MCBS) (CMS-10549)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/29/2020

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	05/31/2021
Responses	11,655	11,699
Time Burden (Hours)	3,947	3,295
Cost Burden (Dollars)	0	0

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Abstract: This OMB generic clearance request is for Medicare Current Beneficiary Survey (MCBS) Questionnaire Testing and Methodological Research. This request encompasses development and testing of MCBS questionnaires, instrumentation, as well as methodological experiments. The MCBS (OMB No. 0938-0568) is an in-person, nationally-representative, longitudinal survey of Medicare beneficiaries.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Research and investigations generally
  

Citations for New Statutory Requirements: None

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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:
	85 FR 66990	10/21/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 83967	12/23/2020
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
CMS-10549 Gen IC # 1 Testing Revisions to Advance Mailing Materials for the Medicare Current Beneficiary Survey	CMS-10549	Advance Letter Report

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	11,655	11,699	0	-44	0	0
Annual Time Burden (Hours)	3,947	3,295	0	652	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: No

Burden Reduction Due to:

Short Statement: Previously, the current estimated burden for this generic clearance was 3,295 hours. An increase in 591 hours is being requested to accommodate additional field testing conducted outside of the production environment (MCBS production is fielded under 0938-0568). This request would bring the total estimated burden for this generic clearance to 3,886 hours.

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Annual Cost to Federal Government: $0

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

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? No

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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: 12/29/2020

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