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Cognitive Testing of the Medical Expenditure Panel Survey (MEPS) Health Insurance Verification Module
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction B1 No   Fillable Fileable
Form and Instruction C1 No   Fillable Fileable

Health Health Care Services

 

444 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 444 0 444 0 0 0
Annual IC Time Burden (Hours) 77 0 77 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement Part A 04/24/2017
Supporting Statement Part B 04/24/2017
Attachment A – Agency for Healthcare Research and Quality (AHRQ) Mission 04/24/2017
Attachment C2 – Cognitive Interview Show Cards 04/24/2017
Attachment C3 – Cognitive Interview Enumeration Template 04/24/2017
Attachment D1 – Thank You (General Population) 04/24/2017
Attachment D2 – Thank You (U.S. Armed Services) 04/24/2017
Attachment D3 – Thank You (Medical Assistance) 04/24/2017
Attachment D4 – Thank You (Affordable Care Act) 04/24/2017
Attachment D5 – Invitation/Recruitment Letter 04/24/2017
Attachment E – Respondent consent form 04/24/2017
Attachment F – OMB Cover Letter 04/24/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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