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 202305-0938-001 · OMB 0938-0732 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-R-246 Medicare Advantage Plan Survey Form and Instruction Modified Available
Form CMS-R-246 Medicare Advantage (MA) Survey Form and Instruction Modified Repair queued
Form CMS-R-264 Prescription Drug Plan survey Form and Instruction Modified Available
Form CMS-R-246 MA-Prescription Drug Plan Survey Form and Instruction Modified Available
Form CMS-R-246 MA-PDP Survey Form and Instruction Modified Repair queued
Form CMS-R-246 Fee-For-Service (FFS) Survey Form and Instruction Modified Available
Form CMS-R-246 Fee-For-Service (FFS) Survey Form and Instruction Modified Repair queued
CMS-R-246 MCAHPS Supporting Statement A.docx Supporting Statement A Uploaded 2023-05-04 Repair queued
CMS-R-246 MCAHPS Supporting Statement B.docx Supporting Statement B Uploaded 2023-05-03 Repair queued
MCAHPS - Crosswalk 2023-1-26.pdf Supplementary Document Uploaded 2023-05-03 Repair queued
CMS Response to Public Comments Received for CMS-R-246_60 Day 04 12 2023 clean.docx Supplementary Document Uploaded 2023-05-03 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8404 Medicare Advantage (MA) Survey Form and Instruction ModifiedMedicare Advantage Plan Survey
8404 Medicare Advantage (MA) Survey Form and Instruction Modified
194258 MA-PDP Survey Form and Instruction ModifiedPrescription Drug Plan survey
194258 MA-PDP Survey Form and Instruction ModifiedMA-Prescription Drug Plan Survey
194258 MA-PDP Survey Form and Instruction Modified
194257 Fee-For-Service (FFS) Survey Form and Instruction ModifiedFee-For-Service (FFS) Survey
194257 Fee-For-Service (FFS) Survey Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2025 36 Months From Approved 01/31/2025
794,500 0 742,350
192,265 0 179,108
0 0 0





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

table that charts list of burden
  Total Approved 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 794,500 742,350 0 52,150 0 0
Annual Time Burden (Hours) 192,265 179,108 0 13,157 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No