National Ambulatory Medical Care Survey (NAMCS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0234 Reinterview Study (2021-2023)	Form and Instruction	New	Repair queued
Form 0920-0234 Prepare and transmit EHR for Visit Data (quarterly) (2021-2023)	Form and Instruction	New	Repair queued
Form 0920-0234 HC Facility Interview (2021-2023)	Form and Instruction	New	Available
Form 0920-0234 PFI (2021-2023)	Form and Instruction	New	Repair queued
Form 0920-0234 Pulling, re-filing medical record forms (FR abstracts) (2021-2023)	Form and Instruction	New	Repair queued
Form 0920-0234 Physician Induction Interview (2021-2023)	Form and Instruction	New	Repair queued
Form 0920-0234 Reinterview Study - Traditional Physician and CHC Staff	Form	Modified	Repair queued
Induction Interview - Community Health Center Providers	Form and Instruction	Removed	Missing upstream
Form 0920-0234 HC Facility Induction Interview (2020)	Form and Instruction	Modified	Repair queued
Induction Interview - Service Delivery Site (NAMCS-201)	Form and Instruction	Removed	Repair queued
Form 0920-2034 Pulling and Refiling Medical Record Forms EHR Onboarding) (2021-2023)	Form and Instruction	Modified	Repair queued
Form 0920-0234 Pulling, re-filing medical record forms (FR abstracts) (2020)	Form	Modified	Missing upstream
Form 0920-0234 Provider Induction Interview (2020)	Form and Instruction	Modified	Repair queued
Form 0920-0234 Physician Induction Interview (2020)	Form and Instruction	Modified	Available
Att N- 2020 NAMCS Endorsing Organizations.pdf	Supplementary Document	Uploaded 2021-05-28	Repair queued
Att M2- 2021 NAMCS Advance Letters.pdf	Supplementary Document	Uploaded 2021-05-28	Repair queued
Att M1- 2020 NAMCS Advance Letters.pdf	Supplementary Document	Uploaded 2021-05-28	Missing upstream
Att L- 2020 NAMCS ERB Continuation Letter.pdf	Supplementary Document	Uploaded 2021-05-28	Repair queued
Att K- 2021-2023 Consultants.docx	Supplementary Document	Uploaded 2021-05-28	Repair queued
Att J- EHR Implementation Guide Templates.pdf	Supplementary Document	Uploaded 2021-05-28	Available
Att I- EHR Implementation Guide.pdf	Supplementary Document	Uploaded 2021-05-28	Repair queued
Att H- EHR Variable List.xlsx	Supplementary Document	Uploaded 2021-05-28	Missing upstream
Att G2- 2021 NAMCS PRF.pdf	Supplementary Document	Uploaded 2021-05-28	Missing upstream
Att G1- 2020 NAMCS PRF.pdf	Supplementary Document	Uploaded 2021-05-28	Missing upstream
Att D- 2020 BSC NAMCS Workgroup Meeting Summary.docx	Supplementary Document	Uploaded 2021-05-28	Missing upstream
Att C3- 2020 Draft FR Incentive Script.docx	Supplementary Document	Uploaded 2021-05-28	Repair queued
Att B- 60 Day Notice.docx	Supplementary Document	Uploaded 2021-05-28	Available
Att A- Authorizing Legislation 012519.pdf	Supplementary Document	Uploaded 2021-05-28	Repair queued
2021 NAMCS Supporting Statement B_4.21.2021 (1).docx	Supporting Statement B	Uploaded 2021-05-28	Repair queued
2021 NAMCS Supporting Statement A_4.21.2021 (1).docx	Supporting Statement A	Uploaded 2021-05-28	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
247679	Reinterview Study (2021-2023)	Form and Instruction	New
247678	Prepare and transmit EHR for Visit Data (quarterly) (2021-2023)	Form and Instruction	New
247676	HC Facility Interview (2021-2023)	Form and Instruction	New
247675	PFI (2021-2023)	Form and Instruction	New
247672	Pulling, re-filing medical record forms (FR abstracts) (2021-2023)	Form and Instruction	New
247670	Physician Induction Interview (2021-2023)	Form and Instruction	New
235134	Reinterview Study - Traditional Physician and CHC Staff	Form	Modified
235133	MU Physician Pulling and Refiling EHR	Instruction	Removed
235132	Induction Interview - Community Health Center Providers	Form and Instruction	Removed
220064	Reabstraction Study - Traditional and CHC Providers	Instruction	Removed
220059	HC Facility Induction Interview (2020)	Form and Instruction	Modified
220058	Induction Interview - Service Delivery Site (NAMCS-201)	Form and Instruction	Removed
213885	Pulling and Refiling Medical Record Forms EHR Onboarding) (2021-2023)	Form and Instruction	Modified
213884	Pulling, re-filing medical record forms (FR abstracts) (2020)	Form	Modified
213883	Provider Induction Interview (2020)	Form and Instruction	Modified
213881	Physician Induction Interview (2020)	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0234	ICR Reference No: 202105-0920-006
Status: Received in OIRA	Previous ICR Reference No: 202007-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0234
Title: National Ambulatory Medical Care Survey (NAMCS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/01/2021

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	05/31/2022
Responses	69,872	46,013
Time Burden (Hours)	6,819	5,038
Cost Burden (Dollars)	0	179,568

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Abstract: The purpose of NAMCS 2021-2023 is to meet the needs and demands for statistical information about the provision of ambulatory medical care services in the United States; this fulfills one of NCHS missions, to monitor the nation's health. Additional justifications for conducting NAMCS include the need for more complete data to study: (1) the performance of the U.S. health care system, (2) care for the rapidly aging population, (3) changes in services such as health insurance coverage change, (4) the introduction of new medical technologies, (5) the use of HCs in the health care community, and (6) the use of EHRs.

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Authorizing Statute(s): PL: Pub.L. 111 - 5 1512 Name of Law: American Recovery and Reinvestment Act of 2009
   US Code: 42 USC 242K Name of Law: Public Health Service Act
  

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:
	86 FR 7398	01/28/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 28837	05/28/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 12

table that charts list of burden

IC Title	Form No.	Form Name
HC Facility Induction Interview (2020)	0920-0234	Att F1- 2020 NAMCS-201 CHC Service Delivery Site
HC Facility Interview (2021-2023)	0920-0234	CHC Facility Interview Questionnaire
Induction Interview - Community Health Center Providers	none, none	2018 CHC Provider Induction Sample Card ,   2019 CDC Provider Questions
Induction Interview - Service Delivery Site (NAMCS-201)	none, none, none	2018 CHC Provider Induction Sample Card ,   2019 CHC Provider Induction Interview ,   CDC Service Delivery Induction Interview Sample Card
MU Physician Pulling and Refiling EHR
PFI (2021-2023)	0920-0234	Att C2- 2021 NAMCS-1 Traditional Physician
Physician Induction Interview (2020)	0920-0234	Att P2- 2021 Census Reinterview Instrument
Physician Induction Interview (2021-2023)	0920-0234	Physician Induction Interview (2021-2023)
Prepare and transmit EHR for Visit Data (quarterly) (2021-2023)	0920-0234	EHR Pulling Records
Provider Induction Interview (2020)	0920-0234	HC Facility Induction Interview (2020)
Pulling and Refiling Medical Record Forms EHR Onboarding) (2021-2023)	0920-2034	EHR Pulling Records Burden
Pulling, re-filing medical record forms (FR abstracts) (2020)	0920-0234, 0920-0234	Att R- 2021 EHR Pulling Records Burden ,   PRF Burden Abstract
Pulling, re-filing medical record forms (FR abstracts) (2021-2023)	0920-0234	Att C2- 2021 NAMCS-1 Traditional Physician
Reabstraction Study - Traditional and CHC Providers
Reinterview Study (2021-2023)	0920-0234	Reinterview Study (2021-2023)
Reinterview Study - Traditional Physician and CHC Staff	0920-0234	2020 Reinterview Instrument

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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	69,872	46,013	0	23,975	-116	0
Annual Time Burden (Hours)	6,819	5,038	0	1,839	-58	0
Annual Cost Burden (Dollars)	0	179,568	0	-174,318	-5,250	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: Yes

Burden Reduction Due to: Changing Forms

Short Statement: The goal of the study is to assess the health of the population through patient use of physician offices and community health centers, which include federally-qualified health centers (FQHC), FQHC look-alikes, and Urban Indian Health Centers, and to monitor the characteristics of physician practices. This IC is requesting approval of 6,819 burden hours.

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Annual Cost to Federal Government: $11,747,341

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.     Yes

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.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

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? Yes

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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: 06/01/2021

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