Attachment A: Federal Register Notice

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Federal Register / Vol. 91, No. 145 / Thursday, July 30, 2026 / Notices
EXHIBIT 1—ESTIMATED BURDEN HOURS OVER 3 YEARS—Continued
Type of information collection

Number of
respondents

Number of
responses per
respondent

10,900

N/A

Total ........................................................................................................

Hours per
response

Total burden
hours

N/A

3,383

* May include telephone non-response follow-up in which case the burden will not change.

EXHIBIT 2—ESTIMATED COST BURDEN OVER 3 YEARS
Number of
respondents

Total burden
hours

Average
hourly wage
rate *

Adjusted
average
hourly wage
rate **

Total cost burden
(total burden
hours × adjusted
average hourly
wage rate)

Mail/email .....................................................................
Telephone ....................................................................
Web-based ...................................................................
Focus Groups ..............................................................
In-person ......................................................................

5,000
200
5,000
500
200

1,250
133
833
1,000
167

$33.54
33.54
33.54
33.54
33.54

$67.08
67.08
67.08
67.08
67.08

$83,850
8,922
55,878
67,080
11,202

Total ......................................................................

10,900

3,383

33.54

67.08

226,932

Type of information collection

* Bureau of Labor & Statistics on ‘‘Occupational Employment and Wages, May 2025’’ for all occupations found at the following URL: National
Occupational Employment and Wage Estimates (bls.gov) for the respondents.
** Adjusted Average Hourly Wage Rate is 200% of the average hourly rate. It is a fully loaded rate that includes the benefit costs of
respondents.

Request for Comments

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In accordance with the Paperwork
Reduction Act, 44 U.S.C. 3501–3520,
comments on AHRQ’s information
collection are requested with regard to
any of the following: (a) whether the
proposed collection of information is
necessary for the proper performance of
AHRQ’s health care research and health
care information dissemination
functions, including whether the
information will have practical utility;
(b) the accuracy of AHRQ’s estimate of
burden (including hours and costs) of
the proposed collection(s) of
information; (c) ways to enhance the
quality, utility and clarity of the
information to be collected; and (d)
ways to minimize the burden of the
collection of information upon the
respondents, including the use of
automated collection techniques or
other forms of information technology.
Comments submitted in response to
this notice will be summarized and
included in the Agency’s subsequent
request for OMB approval of the
proposed information collection. All
comments will become a matter of
public record.
Dated: July 27, 2026.
Jeffrey Toven,
Executive Officer.
[FR Doc. 2026–15326 Filed 7–29–26; 8:45 am]
BILLING CODE 4160–90–P

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DEPARTMENT OF HEALTH AND
HUMAN SERVICES

REPORTSCLEARANCEOFFICER@
ahrq.hhs.gov.

Agency for Healthcare Research and
Quality

SUPPLEMENTARY INFORMATION:

Agency Information Collection
Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research

and Quality, HHS.
ACTION: Information collection notice.
SUMMARY: This notice announces the

intention of the Agency for Healthcare
Research and Quality (AHRQ) to request
that the Office of Management and
Budget (OMB) approve the extension
with change of the currently approved
information collection ‘‘AHRQ
Consumer Assessment of Healthcare
Providers and Systems (CAHPS)
Database for Health Plans’’ (OMB
Control number 0935–0165, last
approved on December 31, 2023).
DATES: Comments on this notice must be
received by September 28, 2026.
ADDRESSES: Written comments should
be submitted to: Margie Shofer, Reports
Clearance Officer, AHRQ, by email at
REPORTSCLEARANCEOFFICER@
ahrq.hhs.gov.
Copies of the proposed collection
plans, data collection instruments, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Margie Shofer, AHRQ Reports Clearance
Officer, (301) 427–1696, or by email at

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Background
The CAHPS Health Plan Database
consists of data from the AHRQ CAHPS
Health Plan Survey. Health plans in the
U.S. are asked to voluntarily submit
data from the survey to AHRQ, through
its contractor, Westat. The CAHPS
Health Plan Survey is a tool for
collecting standardized information on
enrollees’ experiences with health plans
and their services. The development of
the CAHPS Health Plan Survey began in
1995 in response to requests from health
plans, purchasers, and the Centers for
Medicare and Medicaid Services (CMS)
to provide comparative data to support
public reporting of health plan ratings,
health plan accreditation and quality
improvement. Since that time, the
survey has been refined and updated to
reflect field feedback from industry
experts; reports from health plan
participants, data collection vendors
(the organization that helps carry out
the technical and operational parts of a
survey and database submission), and
other users; evidence from cognitive
testing and focus groups; and extensive
psychometric data analysis. Version 5.0
of the Health Plan Survey was released
in 2012. The National Quality Forum
endorsed the 5.0 version of the Health
Plan Survey in 2015. Version 5.1 was
released in 2020 to acknowledge the
various ways in which enrollees may

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Federal Register / Vol. 91, No. 145 / Thursday, July 30, 2026 / Notices

receive care: in person, by phone, or by
video.
The collection of information for the
CAHPS Health Plan Database is being
conducted through its contractor,
Westat, pursuant to AHRQ’s statutory
authority to conduct and support
research on health care and systems for
the delivery of such care, including
activities with respect to the quality,
effectiveness, efficiency,
appropriateness and value of health care
services, quality measurement and
development, and database
development. See 42 U.S.C. 299a(a)(1),
(2), and (8).

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Rationale for the Information
Collection
The CAHPS Health Plan Database
uses data from AHRQ’s standardized
CAHPS Health plan survey to provide
results to health care purchasers,
consumers, regulators and policy
makers across the country. Voluntary
participants include public and private
employers, State Medicaid agencies,
Children’s Health Insurance Programs
(CHIP), CMS, and individual health
plans.
This research seeks to answer the
following questions:
1. What are the key drivers of member
experience in health plans?
2. How do member experiences with
health plans vary across the West,
Midwest, South and Northeast regions?
3. What are the highest and lowest
scoring measures in specific areas of
care for health plans?
This research has the following goals:
1. To maintain the CAHPS Health
Plan database using data from AHRQ’s
standardized CAHPS Health Plan survey
to provide results to health care
purchasers, consumers, regulators and
policy makers across the country.
2. To offer several products and
services, including aggregated results
presented through summary chartbooks,
custom analyses, and data for research
purposes.
3. To provide state-level data to CMS
for public reporting on Medicaid.gov
and Data.Medicaid.gov that does not
display the name of the health plans.
Key Project Components
Each year State Medicaid agencies,
and individual health plans decide
whether to participate in the database
and prepare their materials and dataset
for submission to the CAHPS Health
Plan Database. Participating
organizations are typically State
Medicaid agencies with multiple health
plans. However, individual health plans
are also encouraged to submit their data
to the CAHPS Database. The number of

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data submissions per registrant varies
from participant to participant and year
to year because some participants
submit data for multiple health plans,
while others may only submit survey
data for one plan.
Each organization that decides to
participate in the database must have
their point-of-contact (POC) complete a
registration form providing their contact
information for access to the online data
submission system, sign and submit a
Data Use Agreement (DUA), and provide
health plan characteristics such as
health plan name, product type, type of
population surveyed, health plan state,
and plan name to appear in the
reporting of their results.
Each vendor that submits files on
behalf of a Medicaid agency or
individual health plan must also
complete the registration form in order
to obtain access to the online
submission system. The vendor, on
behalf of their client, may also complete
additional information about survey
administration, submit a copy of the
questionnaire used, and submit one data
file per health plan.
Proposed Revisions
The only change to the data collection
is a small increase in burden, which is
based on an increase in data file
submissions in 2025, the most recent
reported data available. The individual
data submission process did not have an
increased burden but there was an
increase in the total volume of data file
submissions.
Method of Collection
To achieve the goals of this project the
following activities and data collections
will be implemented:
1. Program Recruitment. Outreach
will be conducted with the CAHPS
Health Plan user community (including
state agencies, independent health
plans, survey vendors, etc.) to promote
the database and its benefits, and to
encourage voluntary contributions of
survey data. A variety of
communications will be used (e.g.,
GovDelivery announcements, personal
email messages, conference and meeting
presentations, etc.) to present the value
case for the database and key dates and
details about submitting data.
2. Data Submission Platform. AHRQ’s
contractor currently provides a webbased user-friendly submission platform
including data submission
specifications; technical assistance and
step-by-step instructions for
participation; analysis programs for data
cleaning and reporting; and DUA to
protect the confidentiality of the

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participating organizations and their
data.
3. Submission Notifications and
Instructions. Clear instructions and
notifications are of paramount
importance for successful submission of
valid data, seamless report
dissemination, and streamlined
communication with survey vendors,
state programs, or other submitters.
Procedures for data submission through
the data submission platform will
include the following:
a. Registration Form—The point-ofcontact (POC), which is the sponsor
from Medicaid agencies and health
plans, and vendors complete a number
of data submission steps and forms,
beginning with the completion of the
online registration form. The purpose of
this form is to collect basic contact
information about the organization and
initiate the registration process.
b. Health Plan Information Form—
The purpose of this form, completed by
the participating sponsor organization,
is to collect background characteristics
of the health plan, such as the name of
the plan, the product type (e.g., HMO,
PPO), the population surveyed (e.g.,
adult Medicaid or child Medicaid). Each
year, the prior year’s plan data are
preloaded in the plan table to lessen
burden on the Sponsor. The Sponsor is
responsible for updating the plan table
to reflect the current year’s plan
information.
c. DUA—The purpose of the DUA,
completed by the participating sponsor
organization, is to state how data
submitted by health plans will be used
and provide confidentiality assurances.
d. Data Files Submission—POCs
upload their data file using the Health
Plan data file specifications to ensure
that users submit standardized and
consistent data in the way variables are
named, coded, and formatted. Each
submitter will provide a copy of their
questionnaire and the survey data file in
the required file format. Survey data
files must conform to the data file layout
specifications provided by the CAHPS
Database. Submitters will upload one
data file per health plan. Once a data
file is uploaded the file will be checked
automatically to ensure it conforms to
the specifications and a data file status
report will be produced and made
available to the submitter. Submitters
will review each report and will be
expected to fix any errors in their data
file and resubmit them if necessary.
4. Data Cleaning and Preparation.
Thorough data cleaning and data
preparation are extremely important in
maintaining the integrity of the data and
for analyzing the data in a valid and
reliable way. During data submission,

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Federal Register / Vol. 91, No. 145 / Thursday, July 30, 2026 / Notices
submitters and AHRQ’s contractor’s
database team will review survey
response frequencies to identify out-ofrange values, missing variables, or other
data anomalies such as when
unexpected responses are detected (e.g.,
an unusually large proportion of ‘‘0’’
responses on a 0–10 response scale). A
submission status report will inform
submitters of such errors so that the file
can be corrected and resubmitted. Once
the data submission period closes, SAS®
software will be used for data cleaning,
analysis, and reporting.
5. Data Analysis and Reporting. Using
reporting systems, the contractor will
develop reporting products with

appropriate data visualization
techniques to present results that are
meaningful and useful.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated burden
hours for the respondent to participate
in the database. The 129 POCs in
Exhibit 1 are a combination of an
estimated 114 State Medicaid agencies
and individual health plans (sponsors),
and 15 vendor organizations.
Each sponsor (made up of state
Medicaid agencies and health plans)
and vendor will register online for
submission. The Registration Form will
require about 5 minutes to complete.
Each sponsor will also complete a

Health Plan Information Form which
takes on average 30 minutes to complete
per health plan with each POC
completing the form for four plans on
average. The DUA will be completed by
the 114 participating State Medicaid
agencies or individual health plans.
Vendors do not sign or submit DUAs.
The DUA requires about 5 minutes to
sign and upload. Data File Submissions
will be completed by either sponsors or
vendors for the 114 participating
submitters and will take about 1 hour to
submit the data for each plan, and each
POC will submit data for four plans on
average. The total burden is estimated to
be 893 hours annually.

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents

Number of
responses per
respondent

Registration Form ............................................................................................
Health Plan Information Form .........................................................................
Data Use Agreement .......................................................................................
Data Files Submission .....................................................................................

129
114
114
114

1
4
1
5.65

5/60
30/60
5/60
1

11
228
10
644

Total ..........................................................................................................

471

NA

NA

893

Average
hourly wage
rate *

Adjusted
hourly wage
rate **

Form name

Exhibit 2 shows the estimated
annualized cost burden based on the
respondents’ time to complete one

Hours per
response

Total burden
hours

submission process. The cost burden is
estimated to be $100,115 annually.

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Total burden
hours

Form name
Registration Form ............................................................................................
Health Plan Information Form .........................................................................
Data Use Agreement .......................................................................................
Data Files Submission .....................................................................................

11
228
10
644

Total ..........................................................................................................

893

a 67.77

Total cost
burden

c 50.56

$135.54
135.54
259.26
101.12

1,491
$30,903
2,593
65,128

NA

NA

100,115

a 67.77
b 129.63

* National Compensation Survey: Occupational wages in the United States May 2025, ‘‘U.S. Department of Labor, Bureau of Labor Statistics.’’
** The Adjusted Hourly Rate was estimated at 200% of the hourly wage.
(a) Based on the mean hourly wage for Medical and Health Services Managers (11–9111).
(b) Based on the mean hourly wage for Chief Executives (11–1011).
(c) Based on the mean hourly wages for Computer Programmers (15–1251).

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Request for Comments
In accordance with the Paperwork
Reduction Act, 44 U.S.C. 3501–3520,
comments on AHRQ’s information
collection are requested with regard to
any of the following: (a) whether the
proposed collection of information is
necessary for the proper performance of
AHRQ’s health care research and health
care information dissemination
functions, including whether the
information will have practical utility;
(b) the accuracy of AHRQ’s estimate of
burden (including hours and costs) of
the proposed collection(s) of

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information; (c) ways to enhance the
quality, utility and clarity of the
information to be collected; and (d)
ways to minimize the burden of the
collection of information upon the
respondents, including the use of
automated collection techniques or
other forms of information technology.
Comments submitted in response to
this notice will be summarized and
included in the Agency’s subsequent
request for OMB approval of the
proposed information collection. All
comments will become a matter of
public record.

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Dated: July 27, 2026.
Jeffrey Toven,
Executive Officer.
[FR Doc. 2026–15324 Filed 7–29–26; 8:45 am]
BILLING CODE 4160–90–P

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