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: 0938-1240	ICR Reference No: 202107-0938-015
Status: Active	Previous ICR Reference No: 201807-0938-016
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: National Implementation of the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey (CMS-10500)
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: 11/23/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/30/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2024	36 Months From Approved	12/31/2021
Responses	993,300	0	641,224
Time Burden (Hours)	221,100	0	155,208
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	993,300	641,224	352,076
Annual Time Burden (Hours)	221,100	155,208	65,892
Annual Cost Burden (Dollars)	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 total number of HOPDs and ASCs that have chosen to participate has increased over time. CMS plans to all the introduction of two web-based mixed-modes of administration: web with mail follow-up of non-respondents and web with telephone follow-up of non-respondents. The current burden tables reflect the increase in participation rates for the facilities (from 2,104 to 3,300 HOPDs and ASCs). This increase in participation an increase beneficiaries has resulted in an increase of burden of 65,892 hours.

Annual Cost to Federal Government: $1,600,000

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]? 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)? No

Is this ICR related to the Pandemic Response? No

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