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

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-R-246 Medicare Advantage Plan Survey - Vietnamese	Form and Instruction	Modified	Repair queued
Form CMS-R-246 Medicare Advantage Plan Survey - Tagalog	Form and Instruction	Modified	Available
Form CMS-R-246 Medicare Advantage Plan Survey - Spanish	Form and Instruction	Modified	Available
Form CMS-R-246 Medicare Advantage Plan Survey - Korean	Form and Instruction	Modified	Available
Form CMS-R-246 Medicare Advantage Plan Survey - Chinese	Form and Instruction	Modified	Available
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-246 Prescription Drug Plan Survey - Vietnamese	Form and Instruction	Modified	Repair queued
Form CMS-R-246 Medicare Advantage and Prescription Drug Plan Survey - Vietnamese	Form and Instruction	Modified	Repair queued
Form CMS-R-246 Prescription Drug Plan Survey - Tagalog	Form and Instruction	Modified	Repair queued
Form CMS-R-246 Medicare Advantage and Prescription Drug Plan Survey - Tagalog	Form and Instruction	Modified	Available
Form CMS-R-246 Prescription Drug Plan Survey - Spanish	Form and Instruction	Modified	Repair queued
Form CMS-R-246 Medicare Advantage and Prescription Drug Plan Survey - Spanish	Form and Instruction	Modified	Repair queued
Form CMS-R-246 Prescription Drug Plan Survey - Korean	Form and Instruction	Modified	Repair queued
Form CMS-R-246 Medicare Advantage and Prescription Drug Plan Survey - Korean	Form and Instruction	Modified	Repair queued
Form CMS-R-246 Prescription Drug Plan Survey - Chinese	Form and Instruction	Modified	Repair queued
Form CMS-R-264 Medicare Advantage and Prescription Drug Plan Survey - Chinese	Form and Instruction	Modified	Available
Form CMS-R-246 Medicare Advantage and Prescription Drug Plan (MA & PDP) CAHPS 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. Non-Sub Change Request Memo 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-24	Available
CMS-R-246. Non-Sub Change Request Memo 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-24	Repair queued
DRAFT MCAHPS - Crosswalk 2025-2-19.xlsx	Supplementary Document	Uploaded 2025-04-08	Available
DRAFT MCAHPS - Crosswalk 2025-2-19.xlsx	Supplementary Document	Uploaded 2025-04-08	Missing upstream
CMS-R-246_ MCAHPS Supporting Statement A 2025 Non-Sub .docx	Supporting Statement A	Uploaded 2025-04-08	Available
CMS-R-246_ MCAHPS Supporting Statement A 2025 Non-Sub .docx	Supporting Statement A	Uploaded 2025-04-08	Repair queued
CMS-R-246_MCAHPS Supporting Statement B.docx	Supporting Statement B	Uploaded 2024-06-21	Available
CMS-R-246_MCAHPS Supporting Statement B.docx	Supporting Statement B	Uploaded 2024-06-21	Missing upstream

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8404	Medicare Advantage (MA) Survey	Form and Instruction	Modified	Medicare Advantage Plan Survey - Vietnamese
8404	Medicare Advantage (MA) Survey	Form and Instruction	Modified	Medicare Advantage Plan Survey - Tagalog
8404	Medicare Advantage (MA) Survey	Form and Instruction	Modified	Medicare Advantage Plan Survey - Spanish
8404	Medicare Advantage (MA) Survey	Form and Instruction	Modified	Medicare Advantage Plan Survey - Korean
8404	Medicare Advantage (MA) Survey	Form and Instruction	Modified	Medicare Advantage Plan Survey - Chinese
8404	Medicare Advantage (MA) Survey	Form and Instruction	Modified	Medicare Advantage Plan Survey
8404	Medicare Advantage (MA) Survey	Form and Instruction	Modified
194258	MA-PDP Survey	Form and Instruction	Modified	Prescription Drug Plan Survey - Vietnamese
194258	MA-PDP Survey	Form and Instruction	Modified	Medicare Advantage and Prescription Drug Plan Survey - Vietnamese
194258	MA-PDP Survey	Form and Instruction	Modified	Prescription Drug Plan Survey - Tagalog
194258	MA-PDP Survey	Form and Instruction	Modified	Medicare Advantage and Prescription Drug Plan Survey - Tagalog
194258	MA-PDP Survey	Form and Instruction	Modified	Prescription Drug Plan Survey - Spanish
194258	MA-PDP Survey	Form and Instruction	Modified	Medicare Advantage and Prescription Drug Plan Survey - Spanish
194258	MA-PDP Survey	Form and Instruction	Modified	Prescription Drug Plan Survey - Korean
194258	MA-PDP Survey	Form and Instruction	Modified	Medicare Advantage and Prescription Drug Plan Survey - Korean
194258	MA-PDP Survey	Form and Instruction	Modified	Prescription Drug Plan Survey - Chinese
194258	MA-PDP Survey	Form and Instruction	Modified	Medicare Advantage and Prescription Drug Plan Survey - Chinese
194258	MA-PDP Survey	Form and Instruction	Modified	Medicare Advantage and Prescription Drug Plan (MA & PDP) CAHPS Survey
194258	MA-PDP Survey	Form and Instruction	Modified
194257	Fee-For-Service (FFS) Survey	Form and Instruction	Modified	Fee-For-Service (FFS) Survey
194257	Fee-For-Service (FFS) Survey	Form and Instruction	Modified

ICR Details

OMB Control No: 0938-0732	ICR Reference No: 202504-0938-008
Status: Historical Active	Previous ICR Reference No: 202406-0938-010
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Medicare Advantage, Medicare Part D, and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey (CMS-R-246)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/30/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/24/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2027	11/30/2027	11/30/2027
Responses	794,500	0	794,500
Time Burden (Hours)	192,265	0	192,265
Cost Burden (Dollars)	0	0	0

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Abstract: CMS has fielded the MA (Consumer Assessment of Health Care Providers and Systems) CAHPS Survey annually since 1998, the Medicare FFS CAHPS Survey annually since 2000, and the MA DP and Stand Alone PDP CAHPS survey annually since 2006. The Medicare CAHPS is a national survey of health and prescription drug plans conducted at the contract level for MA, MA PD and Stand Alone PDP plans and at the state level for Medicare fee-for-service. Medicare CAHPS provides data to permit preparation of plan performance measures to assist Medicare beneficiaries in their selection of a health and/or prescription drug plan and help policymakers and others assist the Medicare program and Medicare plans design and monitor patient-centered quality improvement initiatives. The 2009 Call letter for MA and MA PD plans requires these plans to contract with private vendors from a list selected by CMS to conduct the 2011 Medicare CAHPS survey for their plan at the contract level and provide the collected data to CMS for analyses and preparation of CAHPS measures for use in consumer and plan reports and for quality improvement purposes for MA, MA PD, and Stand Alone PDP plans. CMS will continue to collect the Medicare FFS CAHPS data from surveys at the state and some sub-state levels. This revision to a currently approved collection is to add questions focusing on care coordination. The Medicare CAHPS survey has taken the OMB No. 0935-0732.

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Authorizing Statute(s): PL: Pub.L. 108 - 173 1860D Name of Law: Information to Facilitate Enrollment
  

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:
	89 FR 24008	04/05/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 53107	06/25/2024
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Fee-For-Service (FFS) Survey	CMS-R-246	Fee-For-Service (FFS) Survey
MA-PDP Survey	CMS-R-246, CMS-R-264, CMS-R-246, CMS-R-246, CMS-R-246, CMS-R-246, CMS-R-246, CMS-R-246, CMS-R-246, CMS-R-246, CMS-R-246	Medicare Advantage and Prescription Drug Plan (MA & PDP) CAHPS Survey ,   Medicare Advantage and Prescription Drug Plan Survey - Chinese ,   Prescription Drug Plan Survey - Chinese ,   Medicare Advantage and Prescription Drug Plan Survey - Korean ,   Prescription Drug Plan Survey - Korean ,   Medicare Advantage and Prescription Drug Plan Survey - Spanish ,   Prescription Drug Plan Survey - Spanish ,   Medicare Advantage and Prescription Drug Plan Survey - Tagalog ,   Prescription Drug Plan Survey - Tagalog ,   Medicare Advantage and Prescription Drug Plan Survey - Vietnamese ,   Prescription Drug Plan Survey - Vietnamese
Medicare Advantage (MA) Survey	CMS-R-246, CMS-R-246, CMS-R-246, CMS-R-246, CMS-R-246, CMS-R-246	Medicare Advantage Plan Survey ,   Medicare Advantage Plan Survey - Chinese ,   Medicare Advantage Plan Survey - Korean ,   Medicare Advantage Plan Survey - Spanish ,   Medicare Advantage Plan Survey - Tagalog ,   Medicare Advantage Plan Survey - Vietnamese

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ICR Summary of Burden

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	794,500	0	0	0	0
Annual Time Burden (Hours)	192,265	192,265	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $7,000,000

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? 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: 04/24/2025

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