Information Collection Request

Medicare Advantage, Medicare Part D, and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey (CMS-R-246)

ICR 202101-0938-013 · OMB 0938-0732 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-R-246 Medicare Advantage (MA) Survey Form and Instruction Modified Repair queued
Form CMS-R-264 MA-PDP Survey Form and Instruction Modified Repair queued
Form CMS-R-246 Fee-For-Service (FFS) Survey Form and Instruction Modified Repair queued
CMS-R-246 - Supporting Statement A.docx Supporting Statement A Uploaded 2021-02-05 Repair queued
CMS-R-246 - Supporting Statement B.docx Supporting Statement B Uploaded 2021-01-29 Repair queued
MCAHPS - Crosswalk 2020.pdf Supplementary Document Uploaded 2021-01-29 Repair queued
Response_to_Comments_60_FRN_CMS-R-246.pdf Supplementary Document Uploaded 2021-01-29 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8404 Medicare Advantage (MA) Survey Form and Instruction Modified
194258 MA-PDP Survey Form and Instruction Modified
194257 Fee-For-Service (FFS) Survey Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 04/30/2021
742,350 799,650
179,108 192,113
0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Medicare Advantage (MA) Survey CMS-R-246 Medicare Advantage Plan Survey
Fee-For-Service (FFS) Survey CMS-R-246 Fee-For-Service (FFS) Survey
MA-PDP Survey CMS-R-264, CMS-R-246 Prescription Drug Plan survey ,   MA-Prescription Drug Plan Survey

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 742,350 799,650 0 0 -57,300 0
Annual Time Burden (Hours) 179,108 192,113 0 0 -13,005 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No