View Information Collection Request (ICR) Package
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Burden
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Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0234
ICR Reference No:
201111-0920-001
Status:
Historical Active
Previous ICR Reference No:
201102-0920-016
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
National Ambulatory Medical Care Survey
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
12/13/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/08/2011
Terms of Clearance:
New modules must be submitted to OMB for approval as substantive changes.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2014
36 Months From Approved
03/31/2013
Responses
528,615
0
71,827
Time Burden (Hours)
46,622
0
11,502
Cost Burden (Dollars)
0
0
0
Abstract:
Data collected from office-based physicians, and community health center providers, concerning patient visits are aggregated to national statistics. Changes are requested for 2012-2014 survey period, including 1) increase sample size to 34 states, 2) modify sampling design from geographic primary sampling unit to list based sample, 3) implement automation of data collection, 4) field new survey components and 5) conduct a pretest in Spring 2012 to evaluate ability to collect current procedural terminology codes. Other survey activities will continue with minor item modifications.
Authorizing Statute(s):
US Code:
42 USC 242K
Name of Law: Public Health Service Act
PL:
Pub.L. 111 - 5 1512
Name of Law: American Recovery and Reinvestment Act of 2009
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
75 FR 39947
10/13/2010
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 68464
11/04/2011
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
10
IC Title
Form No.
Form Name
2012 Asthma Supplement (line 6)
none
Att B - Asthma Supplement
2012 CPT Pretest NAMCS-1 (line 9)
none
Att Z - NAMCS 2011 Panel CPT Code Pretest
2012 Pretest NAMCS Patient Record Form (line 10)
none
Att BB - NAMCS 2012 - Patient Record Form CPT Code Pretest
Lookback Module (Line 5)
none
Att E - 2012 NAMCS Lookback Module
NAMCS-1 Physician Induction Interview (Line 1)
none
National Ambulatory Medical Care Survey Panel 2011
NAMCS-201 Community Health Center Induction Interview (Line 2)
none
Att K - Community Health Center Induction Interview
NAMCS-30 Patient Record form (Line 3)
none
Att H - NAMCS 2012 Patient Record
National Electronic Health Records Survey (line 7)
none
National Electronic Health Records Survey 2012
Physician Workflow Survey (line 8)
none, none
Att N - 2012 Physician Workflow Supplement - EHR Adopters
,
Att O - 2012 Physician Workflow Supplelment - EHR Nonadopters
Pulling and re-filing Patient Record form (Line 4)
ICR Summary 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
528,615
71,827
0
456,788
0
0
Annual Time Burden (Hours)
46,622
11,502
0
35,120
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The estimated annualized burden hours are higher because there are more planned activities for the 2012-2014 survey period.
Annual Cost to Federal Government:
$11,399,149
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
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]?
Yes
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)?
Yes
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Daniel Holcomb 770 488-4472 dwh6@cdc.gov
Common Form ICR:
No
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:
11/08/2011
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