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: 202003-0938-016
Status: Historical Active	Previous ICR Reference No: 201607-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
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: 12/10/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/24/2020
Terms of Clearance: Previous terms continue: 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 and present a report to OMB.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2023	36 Months From Approved	12/31/2020
Responses	43,872	0	56,972
Time Burden (Hours)	9,354	0	12,754
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	43,872	56,972	-13,100
Annual Time Burden (Hours)	9,354	12,754	-3,400
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: The proposed revisions reduce our estimated completion time per survey from 12 to 11 minutes for PDP survey responses, and from 14 to 13 minutes for MA responses. On an annualized basis, the estimate of respondent burden is also reduced from the estimate provided in our 2017 OMB application due to a reduction in response rates from ~40% (2017 OMB application assumption) to ~30% (based on observed response rates for the survey in years 2016 and 2017). Total burden has decreased from 12,754 to 9,354.

Annual Cost to Federal Government: $1,717,335

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. 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? No

Agency Contact: Stephan McKenzie 410 786-1943 stephan.mckenzie@cms.hhs.gov