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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:
0938-1113
ICR Reference No:
201607-0938-007
Status:
Historical Active
Previous ICR Reference No:
201307-0938-003
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
Implementation of the Medicare Prescription Drug Plan (PDP) and Medicare Advantage (MA) Plan Disenrollment Reasons Survey (CMS-10316)
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:
05/08/2017
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/14/2016
Terms of Clearance:
When four years of data are available, CMS will evaluate the within-plan temporal variability in quality scores available to consumers and adjust the frequency of the data collection accordingly. If there is very little change in the quality scores across time, CMS will consider collecting the information less frequently.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2020
36 Months From Approved
05/31/2017
Responses
56,972
0
88,492
Time Burden (Hours)
12,754
0
22,887
Cost Burden (Dollars)
0
0
0
Abstract:
This information collection will survey disenrollees from Medicare Prescription Drug Plans (PDPs) and Medicare Advantage Prescription Drug Plans (MA-PDs). The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) provides a requirement to collect and report performance data for Part D prescription drug plans. Specifically, the MMA under Sec. 1860D-4 (Beneficiary Protections for Qualified Prescription Drug Coverage) requires CMS to conduct consumer satisfaction surveys regarding PDPs and MA-PDs - pursuant to section 1860D-4(d). This data collection complements the satisfaction data collected through the Medicare CAHPS Survey by providing dissatisfaction data in the form of reasons for disenrollment from PDPs and MA-PDs.
Authorizing Statute(s):
Statute at Large:
1 Stat. 1860
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:
81 FR 16184
03/25/2016
30-day Notice:
Federal Register Citation:
Citation Date:
81 FR 42711
06/30/2016
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
Medicare Disenrollee Survey - MA
CMS-10316
Medicare Disenrollee Survey - MA
Medicare Disenrollee Survey - MA-PD
CMS-10316
Medicare Disenrollee Survey - MA PD
Medicare Disenrollment Survey - Stand Alone PDP Version
CMS-10316
Medicare Disenrollee Survey: Prescription Drug Plan
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
56,972
88,492
0
-31,520
0
0
Annual Time Burden (Hours)
12,754
22,887
0
-10,133
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:
This request seeks approval of an estimated 12,754 hours of respondent burden per year to assess reasons for disenrollment from MA and PDP contracts. The actual respondent burden is subject to change between years depending on shifts in number of PDP and MA contracts and/or changes in response rates from year-to-year. It is important to maintain flexibility and consider larger sample sizes that will preserve adequate contract-level reporting reliabilities in the event of increases in the number of PDP and MA contracts and/or declines in response rates. Proposed changes to the 2016 disenrollment surveys are detailed in the attached crosswalks. A handful of items have been deleted due to low rates of endorsement, or because the information is available through administrative sources and thus not necessary to include in the “about you” section of the survey. One item on the effect of Star ratings on disenrollment decisions has been added. In general, revisions have been made to make items easier to for respondents to understand. However, these revisions do not change our estimated completion time per survey. On an annualized basis, the estimate of respondent burden is reduced from the estimate provided in our 2013 OMB application due to -- (1) a reduction in response rates from 50% (2013 OMB application assumption) to 40% (based on observed response rates for the survey in years 2014 and 2015) and (2) reduction in the number of items on the current survey instruments compared with 2013 instruments.
Annual Cost to Federal Government:
$1,649,028
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]?
No
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)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.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:
07/14/2016
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