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OMB Control No: 0938-1240	ICR Reference No: 202402-0938-009
Status: Received in OIRA	Previous ICR Reference No: 202107-0938-015
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: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 02/27/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved	11/30/2024
Responses	2,534,643	993,300
Time Burden (Hours)	614,976	221,100
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	2,534,643	993,300	1,541,343
Annual Time Burden (Hours)	614,976	221,100	393,876
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 total number of HOPDs and ASCs that are expected to participate has increased over time. The current burden tables reflect the increase in participation rates and has resulted in an increase in the annual hourly burden.

Annual Cost to Federal Government: $1,720,000

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