View Information Collection Request (ICR) Package

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: 0938-0568	ICR Reference No: 201605-0938-004
Status: Historical Active	Previous ICR Reference No: 201601-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: 20757
Title: Medicare Current Beneficiary Survey (MCBS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/27/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/09/2016
Terms of Clearance: Approved consistent with the understanding that changes to the MCBS questionnaire will continue to be submitted to OMB for approval, and CMS will update OMB on their ongoing plans for the modernization effort with each submission.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2019	36 Months From Approved	07/31/2017
Responses	49,650	0	49,650
Time Burden (Hours)	60,103	0	58,450
Cost Burden (Dollars)	0	0	0

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

IC Title	Form No.	Form Name
Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	CMS-P-0015A, CMS_P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A	MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS , MCBS

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	49,650	49,650	0
Annual Time Burden (Hours)	60,103	58,450	1,653
Annual Cost Burden (Dollars)	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: There has been a slight increase in the total annual burden estimate. Overall, the ICR has been revised to account for new questions in the survey.