View Information Collection (IC)
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
MEPS-HC Address-Based Sample (ABS) Field Test
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
N/A
Attachment 6 - Round 1 Enumeration
Attachment 6 - Round 1 Enumeration.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Attachment 7 Round 1 Re-Enumeration
Attachment 7 - Round 1 Re-Enumeration.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Attachment 5- Pre R1 Questionnaire
Attachment 5 - Pre-R1 Questionnaire.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
Medical Expenditure Panel Survey (MEPS) and National Medical Expenditure Survey 2 (NMES 2)
FR Citation:
69 FR 17666
Number of Respondents:
500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
60 %
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
500
0
500
0
0
0
Annual IC Time Burden (Hours)
546
0
546
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 1- Pre R1 Invitation Letter
Attachment 1 - Pre-R1 Invitation Letter.docx
08/17/2026
Attachment 2- Pre R1 Reminder Postcard
Attachment 2 - Pre-R1 Reminder Postcard.docx
08/17/2026
Attachment 3- Pre R1 Nonresponse Letter
Attachment 3 - Pre-R1 Nonresponse Letter.docx
08/17/2026
Pre R1 Final Postcard
Attachment 4 - Pre-R1 Final Postcard.docx
08/17/2026
Short form for Generic Clearance for the Questionnaire and Data Collection Testing, Evaluation, and Research for AHRQ
MEPS Gen4 ABS-Field-Test_Generic 0935-Short-Form final .docx
08/20/2026
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.