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OMB Control No: 0938-1113	ICR Reference No: 202304-0938-020
Status: Active	Previous ICR Reference No: 202003-0938-016
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 without change	Conclusion Date: 10/12/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/01/2023
Terms of Clearance: To address previous terms of clearance, the agency provided documentation of the value of the frequency of the data collection, but it remains unclear if the burden associated with this information collection (IC) provides proportional value. Please consider other strategies to reduce burden and streamline this collection. Also prior to the re-submission of IC, we request CMS will assess linguistic preferences across the Medicare population and translate this IC into additional languages as appropriate in order to increase accessibility and reduce health disparities. It is the expectation that CMS will translate this form into more languages that English and Spanish, but the number of additional languages will be based on the agency’s assessment its population needs but these languages could include both Traditional and Simplified Chinese, Vietnamese, Korean, Tagalog, Arabic, French, and Russian.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2024	36 Months From Approved	12/31/2023
Responses	32,750	0	43,872
Time Burden (Hours)	7,055	0	9,354
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:
	88 FR 7976	02/07/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 26311	04/28/2023
Did the Agency receive public comments on this ICR? No

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	32,750	43,872	-11,122
Annual Time Burden (Hours)	7,055	9,354	-2,299
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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: CMS proposes to delete various items and add items to the surveys. The revised MA-PD version has net 1 additional item (3 dropped, 4 added), the MA-Only version has zero net changes (3 dropped, 3 added) and the revised PDP version has zero net changes (3 dropped, 3 added). These changes apply to both the English-language and Spanish-language versions of the survey. The proposed revisions result in no changes in our estimated completion time per survey. On an annualized basis, the estimate of respondent burden is reduced from the estimate provided in our 2019 OMB application due to a reduction in response rates from ~30% (2019 OMB application assumption) to ~20.3% (based on observed response rates for the survey in 2021).

Annual Cost to Federal Government: $1,962,734

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

View ICR - OIRA Conclusion