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OMB Control No: 0938-0653	ICR Reference No: 199405-0938-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: POST LABORATORY SURVEY QUESTIONNAIRE, LABORATORY
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/23/1994
	Date Received in OIRA: 05/25/1994
Terms of Clearance: Approved for use through 9/96 with the understanding that this stand alone survey effort as it is designed is inadequate for evaluating satisfaction with the CLIA survey process, for the laboratory universe or a specific subgroup of laboratories. Although the information may be useful in directing future CLIA efforts, it is unclear whether the proposed sample of 1,560 laboratories is adequate to evaluate laborato opinion by state surveyor jurisdiction or laboratory type, e.g. indepe dent laboratory, hospital-based laboratory, physician laboratory, etc. If such a thorough evaluation is a main objective of HCFA's, OMB staf will work with HCFA to: 1) design a survey that will measure laboratory satisfaction without complicating the effort with program evaluation questions; 2) design a sampling methodology that would enab HCFA to evaluate satisfaction by survey team jurisdiction, laboratory type, test menu complexity, etc.; and 3) design a survey plan that would control for respondent biases that could be introduced as a resu of HCFA's role in regulating laboratories. Such issues must be addressed if HCFA intends to use the results of this effort as measure of client satisfaction or CLIA program performance. Finally, this survey cannot be used to fully evaluate CLIA's impact due to the limit detail in its questions, potential data biases and validity issues, an the limited sample size.OMB continues to encourage HHS to provide a briefing on its progress in evaluating CLIA's impact as required by la

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1996	09/30/1996
Responses	1,560	0	0
Time Burden (Hours)	390	0	0
Cost Burden (Dollars)	0	0	0

Abstract: OPPORTUNITY FOR LABORATORY TO EVALUATE THE SURVEY PROCESS. THIS FORM WILL BE COMPLETED IN CONJUNCTION WITH THE HCFA FORM 668A. THIS INFORMATION WILL HELP HCFA EVALUATE THE SURVEY PROCESS FROM THE LABORATORY'S PROSPECTIVE.

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
POST LABORATORY SURVEY QUESTIONNAIRE, LABORATORY	HCFA 668B

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	1,560	1,560
Annual Time Burden (Hours)	390	390
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

View ICR - OIRA Conclusion