HEDIS Information Collection Request

Forms and Documents

Document Name	Status
Form CMS-10219 HEDIS Information Collection Request Form	New
CMS-10219.Supporting Statement Part B.doc Supporting Statement B	2007-05-07
CMS-10219.Supporting Statement Part A.doc Supporting Statement A	2007-05-07

IC Document Collections

IC ID	Document Title	Status
181326	HEDIS Information Collection Request Form	New

ICR Details

OMB Control No: 0938-1028	ICR Reference No: 200707-0938-012
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: HEDIS Information Collection Request
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/30/2007
	Date Received in OIRA: 07/26/2007
Terms of Clearance: This current submission is only for HEDIS and is being filed as a new submission. The HEDIS ICR requirements were previousely approved under another OMB number.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2010	36 Months From Approved
Responses	705	0	0
Time Burden (Hours)	33,840	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Centers for Medicare & Medicaid Services collects quality performance measures in order to hold the Medicare managed care industry accountable for the care being delivered, to enable quality improvement, and to provide quality information to Medicare beneficiaries in order to promote an informed choice. It is critical to CMS' mission that we collect and disseminate information that will help beneficiaries choose among health plans, contribute to improved quality of care through identification of improvement opportunities, and assist CMS in carrying out its oversight and purchasing responsibilities.

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Authorizing Statute(s): PL: Pub.L. 108 - 173 722 (a)(3)(A)(i) Name of Law: MMA
   US Code: 42 USC Sec. 1395w-22(e)(3)(A) Name of Law: Benefits and beneficiary protections
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 8167	02/26/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 21023	04/27/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
HEDIS Information Collection Request	CMS-10219, CMS-10219, CMS-10219, CMS-10219, CMS-10219, CMS-10219, CMS-10219, CMS-10219, CMS-10219, CMS-10219, CMS-10219	CMS-10219.2_Effectiveness of Care A_pp 55-111 ,   CMS-10219.1_General Guidelines_ ,   CMS-10219.3_Effectiveness of Care B_pp 112-178 ,   CMS-10219.4_Access-Availability of Care_pp 179-210. ,   CMS-10219.5_Satisfaction with Care_pp 211-216. ,   CMS-10219.6_Health Plan Stability_pp 217-220 ,   CMS-10219.7_Use of Services A_pp 221-270 ,   CMS-10219.8_Use of Services B_pp 271-302 ,   CMS-10219.9_Cost of Care_pp 303-374 ,   CMS-10219.10_Informed Health Care Choices_pp 375-378 ,   CMS-10219.11_Health Plan Description_pp 379-406

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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	705	0	0	705	0	0
Annual Time Burden (Hours)	33,840	0	0	33,840	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: No

Burden Reduction Due to:

Short Statement: The changes for annual responses, annual hour burden and annual cost burden, reflect a correction to the numbers reported for the prior PRA submission approved in January 2004, as well as a real change in estimated burden. The 2004 submission combined requests for HEDIS and HOS. This current submission is only for HEDIS and is being filed as a new submission. In 2004 there were 169 entities that were required to respond with HEDIS data because they contracted to provide Medicare managed care services. With the passage and implementation of the Medicare Prescription Drug, Improvement and Modernization Act, several hundred entities received contracts to provide Medicare Part D services, bringing the number of respondents up to 705. The annual hour burden decreased substantially because the amount of time it takes to respond to the HEDIS survey has been greatly reduced and more accurate data on the time needed to complete a response was gathered. Thus, with 705 respondents taking 48 hours each to complete the survey, the annual hour burden is only 33,840.

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Annual Cost to Federal Government: $0

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 07/26/2007

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