MA-PDP Survey

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0732 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-R-264 MA-PDP Survey Form and Instruction
CMS-R-246 MA-Prescription Drug Plan Survey MA-PDSurvey.pdf Form and Instruction
CMS-R-264 Prescription Drug Plan survey PDPSurvey.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	MA-PDP Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 423.156

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-R-246	MA-Prescription Drug Plan Survey	MA-PDSurvey.pdf		No		Fillable Fileable
Form and Instruction	CMS-R-264	Prescription Drug Plan survey	PDPSurvey.pdf		No		Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Privacy Act of 1974: HPMS # 09-70-4004	FR Citation: 63 FR 43187

Number of Respondents: 81,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	81,000	-16,500	97,500
Annual IC Time Burden (Hours)	13,770	-2,805	16,575
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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