Agency Information Collection Activities: Proposed Collection; Comment Request, 3908-3911 [2010-1158]
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Federal Register / Vol. 75, No. 15 / Monday, January 25, 2010 / Notices
Message from Medicare (IM); Use:
Requirements that hospitals notify
beneficiaries in inpatient hospital
settings of their rights as a hospital
patient including their discharge appeal
rights are referenced in Section 1866 of
the Social Security Act (The Act). The
authority for the right to an expedited
determination is set forth at Sections
1869 and 1154 of the Act. The hospital
must deliver valid, written notice (the
IM) of a patient’s rights as a hospital
patient including the discharge appeal
rights, within 2 calendar days of
admission. A follow-up copy of the
signed IM is given again as far as
possible in advance of discharge, but no
more than 2 calendar days before.
Follow-up notice is not required if
provision of the admission IM falls
within 2 calendar days of discharge. The
collection has been revised to include
documentation of the time when the
beneficiary signs the document when it
is delivered initially and as a follow up
copy. Form Number: CMS–R–193
(OMB#: 0938–1019); Frequency:
Reporting—Yearly; Affected Public:
Business or other for-profits and Notfor-profit institutions; Number of
Respondents: 3193; Total Annual
Responses: 13,218; Total Annual Hours:
19,680,000. (For policy questions
regarding this collection contact Evelyn
Blaemire at 410–786–1803. For all other
issues call 410–786–1326.)
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Recovery Act—
Reporting Requirements for States
Under FMAP Increase and TMA
Provisions; Use: The American
Recovery and Reinvestment Act of 2009
(Recovery Act), Public Law 111–5,
requires that States submit quarterly
reports to the Secretary of Health and
Human Services in accordance with
section 5001 Temporary Increase of
Medicaid Federal Medical Assistance
Percentage (FMAP) and section 5004(d)
Extension of Transitional Medical
Assistance (TMA). The reports under
section 5001 are required for the period
of October 1, 2008—September 30,
2011. The reports under section 5004
are required beginning on July 1, 2009
until the Federal authority for TMA
coverage sunsets (now scheduled to
sunset on December 31, 2010). Each
State Medicaid agency will submit its
quarterly reports to the appropriate
Regional Office of CMS. The reports will
be compiled and summarized for annual
reports to Congress. Form Number:
CMS–10295 (OMB#: 0938–1073);
Frequency: Reporting—Quarterly;
Affected Public: State, Local, or Tribal
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Governments; Number of Respondents:
50; Total Annual Responses: 200; Total
Annual Hours: 600. (For policy
questions regarding this collection
contact Richard Strauss at 410–786–
2019. For all other issues call 410–786–
1326.)
4. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: State Plan Preprint implementing Section 6087 of the
Deficit Reduction Act: Optional SelfDirection Personal Assistance Services
(PAS) Program (Cash and Counseling);
Form Number: CMS–10234 (OMB#:
0938–1024); Use: Information submitted
via the State Plan Amendment (SPA)
pre-print is used by CMS and Regional
Offices to analyze a State’s proposal to
implement Section 6087 of the Deficit
Reduction Act (DRA). State Medicaid
Agencies will complete the SPA preprint, and submit it to CMS for a
comprehensive analysis. The pre-print
contains assurances, check-off items,
and areas for States to describe policies
and procedures for subjects such as
quality assurance, risk management, and
voluntary and involuntary
disenrollment; Frequency: Reporting—
Once; Affected Public: State, Local, or
Tribal Government; Number of
Respondents: 56; Total Annual
Responses: 20; Total Annual Hours:
400. (For policy questions regarding this
collection contact Carrie Smith at 410–
786–4485. For all other issues call 410–
786–1326.)
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access CMS’ Web site
at https://www.cms.hhs.gov/
PaperworkReductionActof1995, or email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov, or call the
Reports Clearance Office on (410) 786–
1326.
In commenting on the proposed
information collections please reference
the document identifier or OMB control
number. To be assured consideration,
comments and recommendations must
be submitted in one of the following
ways by March 26, 2010:
1. Electronically. You may submit
your comments electronically to https://
www.regulations.gov. Follow the
instructions for ‘‘Comment or
Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) accepting comments.
2. By regular mail. You may mail
written comments to the following
address: CMS, Office of Strategic
Operations and Regulatory Affairs,
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Division of Regulations Development,
Attention: Document Identifier/OMB
Control Number, Room C4–26–05, 7500
Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: January 15, 2010.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2010–1341 Filed 1–22–10; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
SUMMARY: This notice announces the
intention of the Agency for Healthcare
Research and Quality (AHRQ) to request
that the Office of Management and
Budget (OMB) approve the proposed
information collection project:
‘‘Collection of Information for Agency
for Healthcare Research and Quality’s
(AHRQ) Consumer Assessment of
Healthcare Providers and Systems
(CAHPS) Health Plan Survey
Comparative Database.’’ In accordance
with the Paperwork Reduction Act, 44
U.S.C. 3501–3520, AHRQ invites the
public to comment on this proposed
information collection.
DATES: Comments on this notice must be
received by March 26, 2010.
ADDRESSES: Written comments should
be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at doris.lefkowitz@AHRQ.hhs.gov.
Copies of the proposed collection
plans, data collection instruments, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
e-mail at
doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
Collection of Information for Agency
for Healthcare Research and Quality’s
(AHRQ) Consumer Assessment of
Healthcare Providers and Systems
(CAHPS) Health Plan Survey
Comparative Database.
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Federal Register / Vol. 75, No. 15 / Monday, January 25, 2010 / Notices
The Agency for Healthcare Research
and Quality (AHRQ) requests that the
Office of Management and Budget
(OMB) approve, under the Paperwork
Reduction Act of 1995, AHRQ’s
collection of information for the AHRQ
Consumer Assessment of Healthcare
Providers and Systems (CAHPS)
Database for Health Plans. The CAHPS
Health Plan Database consists of data
from the AHRQ CAHPS Health Plan
Survey. Health plans in the U.S. are
asked to voluntarily submit data from
the survey to AHRQ, through its
contractor, Westat. The CAHPS
Database was developed by AHRQ in
1998 in response to requests from health
plans, purchasers, and the Centers for
Medicare & Medicaid Services (CMS) to
provide comparative data to support
public reporting of health plan ratings,
health plan accreditation and quality
improvement.
The CAHPS Health Plan Survey is a
tool for collecting standardized
information on enrollees’ experiences
with health plans and their services.
The development of the CAHPS Health
Plan Survey began in 1995, when AHRQ
awarded the first set of CAHPS grants to
Harvard, RTI, and RAND. In 1997 the
CAHPS 1.0 survey was released by the
CAHPS Consortium. The CAHPS
Consortium refers to the research
organizations involved in the
development, dissemination, and
support of CAHPS products. The
current Consortium includes AHRQ,
CMS, RAND, Yale School of Public
Health, and Westat.
Since that time, the Consortium has
clarified and updated the survey
instrument to reflect field test results;
feedback from industry experts; reports
from health plan participants, data
collection vendors, and other users; and
evidence from cognitive testing and
focus groups. In November 2006, the
CAHPS Consortium released the latest
version of the instrument: The CAHPS
Health Plan Survey 4.0. The
development of this update to the
Health Plan Survey has been part of the
‘‘Ambulatory CAHPS (A–CAHPS)
Initiative,’’ which arose as a result of
extensive research conducted with
users. AHRQ released the CAHPS
Health Plan Survey 4.0, along with
guidance on how to customize and
administer it. The National Quality
Forum endorsed the 4.0 version of the
Health Plan Survey in July 2007.
The CAHPS Health Plan Database
uses data from AHRQ’s standardized
CAHPS Health plan survey to provide
comparative results to health care
purchasers, consumers, regulators and
policy makers across the country. The
Database also provides data for AHRQ’s
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annual National Healthcare Quality and
National Healthcare Disparities Reports.
Voluntary participants include public
and private employers, State Medicaid
agencies, State Children’s Health
Insurance Programs (SCHIP), CMS, and
individual health plans.
The collection of information for the
CAHPS Database for Health Plans is
being conducted pursuant to AHRQ’s
statutory authority to conduct and
support research on health care and
systems for the delivery of such care,
including activities with respect to the
quality, effectiveness, efficiency,
appropriateness and value of health care
services. See 42 U.S.C. 299a(a)(1).
Method of Collection
Information for the CAHPS Health
Plan Database has been collected by
AHRQ through its contractor Westat on
an annual basis since 1998. Health plans
are asked to voluntarily submit their
data to the comparative database in June
of each year. The data are cleaned with
standardized programs, then aggregated
and used to produce comparative results
for commercial (adult and child),
Medicaid (adult and child), and
Medicare (adult) populations for the two
most recent years. In addition,
individual participant reports are
produced that display the participating
organizations’ own results compared to
appropriate comparisons derived from
the National, regional and product-type
distributions on a password-protected
section of the online reporting system.
The CAHPS Health Plan Database
receives the data from three sources.
First, commercial health plan data is
purchased by the CAHPS Health Plan
Database directly from the National
Committee for Quality Assurance
(NCQA). The data is collected by NCQA
from those who participate in its
accreditation program. Second,
Medicare data is provided by CMS
through an agency data use agreement.
The Medicare data is collected by CMS
and their contractor from beneficiaries
who were enrolled in a managed care
health plan. Third, Medicaid data is
collected by the CAHPS Health Plan
Database. Medicaid agencies and their
vendors directly submit their Medicaid
health plan survey data to the CAPHS
Health Plan Database through an online
data submission system. Data submitted
by Medicaid plans are compiled along
with the data received from CMS and
NCQA to comprise the CAHPS Health
Plan Survey comparative database.
Estimated Annual Respondent Burden
Each year State Medicaid agencies
and individual health plans decide
whether to participate in the database
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and prepare their materials and dataset
for submission to the CAHPS Health
Plan Database. Participating
organizations are typically State
Medicaid agencies with multiple health
plans. However, individual health plans
are also encouraged to submit their data
to the CAHPS Database. The number of
data submissions per registrant varies
from participant to participant and year
to year because some participants
submit data for multiple health plans,
while others may only submit survey
data for one plan.
Each organization that decides to
participate in the database must have
their POC complete a registration form
providing their contact information for
access to the on-line data submission
system, sign and submit a data use
agreement (DUA), and provide health
plan characteristics such as health plan
name, product type, type of population
surveyed, health plan state, and plan
name to appear in the reporting of their
results.
Each vendor that submits files on
behalf of a Medicaid agency or
individual health plan must also
complete the registration form in order
to obtain access to the on-line
submission system. The vendor, on
behalf of their client, may also complete
additional information about survey
administration (CAHPS survey version
used, mode of survey administration,
total enrollment count, description of
how the sample was selected), submit a
copy of the questionnaire used, and
submit one data file per health plan.
Commercial health plan data is received
directly from NCQA. Medicare health
plan data is received from CMS.
The burden hours and costs below
pertain only to the collection of
Medicaid data from State Medicaid
agencies and individual Medicaid
health plans because those are the only
entities that submit data through the
data submission process (other data are
obtained directly from NCQA and CMS
as noted earlier in Section 2). In 2009,
a total of 60 participants, representing
45 individual organizations and 15
vendors, submitted data for 244 health
plans (an average of about 4 health
plans per participant).
Exhibits 1 and 2 are based on the
estimated number of individual
participants (participating organizations
and/or vendors) who will complete the
database submission steps and forms in
the coming years, and is not based on
the total number of health plans that are
submitted. The number of respondents
and burden hours are based on an
estimated slight increase in the number
of participants to 70 in 2010 and 2011.
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Federal Register / Vol. 75, No. 15 / Monday, January 25, 2010 / Notices
In Exhibit 1, the 70 participants that
will complete the registration form and
submit information to the CAHPS
Health Plan Database are a combination
of an estimated 50 State Medicaid
agencies and individual health plans,
and 20 estimated vendors. The 50 State
Medicaid agencies or individual health
plans will sign and submit a DUA.
Vendors do not sign or submit DUAs.
Health plan information and data files
are submitted for each health plan.
Exhibit 1 shows an estimated total of
280 health plans (70 estimated
participants with 4 health plans per
participant). The total burden hours for
completing the registration, DUA and
data submission process are estimated
to be 722 hours.
EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents/
POCS
Form name
Number of
responses per
POC
Hours per
response
Total burden
hours
Registration Form and Data Submission * .......................................................
Data Use Agreement ** ....................................................................................
Health Plan Information *** ..............................................................................
70
50
70
1
1
4
7.6
1
30/60
532
50
140
Total ..........................................................................................................
190
NA
NA
722
* The online Registration Form requires about 5 minutes to complete; however, over 7 hours is required to plan/prepare for the data submission. This includes the amount of time the participating organization, and others (CEO, lawyer, vendor) typically spend deciding whether to participate in the database and preparing their materials and dataset for submission to the CAHPS Health Plan Database and performing the submission.
** The Data Use Agreement requires about 3 minutes to complete; however, about 57 minutes is required for the participating organization to
review the agreement prior to signing. This includes the review by the organization’s CEO or legal department.
*** A few health plans may submit their data directly; however, most health plan data will be submitted by the POC.
Exhibit 2 shows the estimated
annualized cost burden based on the
respondents’ time to complete the
submission process. The cost burden is
estimated to be $31,046 annually.
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents
Form name
Total burden
hours
Average
hourly wage
rate **
Total cost
burden
Registration Form and Data Submission * .......................................................
Data Use Agreement .......................................................................................
Health Plan Information ...................................................................................
70
50
70
532
50
140
$43.00
43.00
43.00
$22,876
2,150
6,020
Total ..........................................................................................................
190
722
NA
31,046
* Wage rates were calculated using the mean hourly wage based on occupational employment and wage estimates from the Dept of Labor,
Bureau of Labor Statistics’ May 2008 National Industry-Specific Occupational Employment and Wage Estimates NAICS 622000—located at
https://www.bls.gov/oes/current/oes_nat.htm.
** Wage rate of $43.00 is based on the mean hourly wages for Medical and Health Services Managers. Wage rate of $42.67 is the weighted
mean hourly wage for: Medical and Health Services Managers ($42.67 × 2.6 hours = $110.95), Lawyers ($59.98 × .5 hours = $29.99), Chief Executives ($89.16 × .5 hours = $44.58), and Computer programmer ($35.32 × 4 hours = $141.28) [Weighted mean = ($110.95 + 29.99 + 44.58 +
141.28)/7.6 hours = $326.80/7.6 hours = $43.00/hour].
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Estimated Annual Costs to the Federal
Government
Exhibit 3 shows the estimated
annualized cost to the government for
developing, maintaining and managing
the Health Plan Database and analyzing
the data and reporting results. The cost
is estimated to be $260,000 annually.
Annualized costs for collecting and
processing the CAHPS Health Plan
Database are based upon 10 years of
historical project costs. Start-up costs
were present in the early years of the
database only.
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healthcare information dissemination
functions, including whether the
information will have practical utility;
Annualized (b) the accuracy of AHRQ’s estimate of
Cost component
cost
burden (including hours and costs) of
the proposed collection(s) of
Database Maintenance ...............
$50,000 information; (c) ways to enhance the
Data Submission ........................
100,000
quality, utility, and clarity of the
Data Analysis and Reporting ......
110,000
information to be collected; and (d)
Total ........................................
260,000 ways to minimize the burden of the
collection of information upon the
respondents, including the use of
Request for Comments
automated collection techniques or
In accordance with the above-cited
other forms of information technology.
Paperwork Reduction Act legislation,
Comments submitted in response to
comments on AHRQ’s information
this notice will be summarized and
collection are requested with regard to
included in the Agency’s subsequent
any of the following: (a) Whether the
request for OMB approval of the
proposed collection of information is
proposed information collection. All
necessary for the proper performance of comments will become a matter of
AHRQ healthcare research and
public record.
EXHIBIT 3—ESTIMATED ANNUALIZED
COST
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Federal Register / Vol. 75, No. 15 / Monday, January 25, 2010 / Notices
Dated: January 11, 2010.
Carolyn M. Clancy,
Director.
[FR Doc. 2010–1158 Filed 1–22–10; 8:45 am]
BILLING CODE 4160–90–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
Advisory Board on Radiation and
Worker Health (ABRWH or Advisory
Board), National Institute for
Occupational Safety and Health
(NIOSH)
In accordance with section 10(a)(2) of
the Federal Advisory Committee Act
(Pub. L. 92–463), and pursuant to the
requirements of 42 CFR 83.15(a), the
Centers for Disease Control and
Prevention (CDC), announces the
following meeting of the
aforementioned committee:
Board Public Meeting Times and Dates
(All Times Are Pacific Standard Time)
8:45 a.m.–4:30 p.m., February 9, 2010.
9 a.m.–6 p.m., February 10, 2010.
9 a.m.–3 p.m., February 11, 2010.
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Public Comment Times and Dates (All
Times Are Pacific Standard Time)
4:30 p.m.–6 p.m., February 9, 2010.*
6 p.m.–7:30 p.m., February 10, 2010.*
*Please note that the public comment
periods may end before the times
indicated, following the last call for
comments. Members of the public who
wish to provide public comment should
plan to attend public comment sessions
at the start times listed.
Place: Marriott Manhattan Beach,
1400 Parkview Avenue, Manhattan
Beach, California; Phone: (310) 546–
7511; Fax: (310) 939–1486. Audio
Conference Call via FTS Conferencing.
The USA toll free dial-in number is 1–
866–659–0537 with a pass code of
9933701.
Status: Open to the public, limited
only by the space available. The meeting
space accommodates approximately 100
people.
Background: The Advisory Board was
established under the Energy Employees
Occupational Illness Compensation
Program (EEOICP) Act of 2000 to advise
the President on a variety of policy and
technical functions required to
implement and effectively manage the
new compensation program. Key
functions of the Advisory Board include
providing advice on the development of
probability of causation guidelines
which have been promulgated by the
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Department of Health and Human
Services (HHS) as a final rule, advice on
methods of dose reconstruction which
have also been promulgated by HHS as
a final rule, advice on the scientific
validity and quality of dose estimation
and reconstruction efforts being
performed for purposes of the
compensation program, and advice on
petitions to add classes of workers to the
Special Exposure Cohort (SEC).
In December 2000, the President
delegated responsibility for funding,
staffing, and operating the Advisory
Board to HHS, which subsequently
delegated this authority to the CDC.
NIOSH implements this responsibility
for CDC. The charter was issued on
August 3, 2001, renewed at appropriate
intervals, and will expire on August 3,
2011.
Purpose: This Advisory Board is
charged with (a) Providing advice to the
Secretary, HHS, on the development of
guidelines under Executive Order
13179; (b) providing advice to the
Secretary, HHS, on the scientific
validity and quality of dose
reconstruction efforts performed for this
program; and (c) upon request by the
Secretary, HHS, advise the Secretary on
whether there is a class of employees at
any Department of Energy facility who
were exposed to radiation but for whom
it is not feasible to estimate their
radiation dose, and on whether there is
reasonable likelihood that such
radiation doses may have endangered
the health of members of this class.
Matters To Be Discussed: The agenda
for the Advisory Board meeting
includes: NIOSH Program Update and
Program Evaluation Plans; Department
of Labor (DOL) Program Update;
Department of Energy (DOE) Program
Update; OCAS Science Update; Special
Exposure Cohort (SEC) petitions for:
Lawrence Livermore National
Laboratory, Santa Susana Area IV,
Canoga Avenue Facility (Los Angeles
County, California), Lawrence Berkeley
National Laboratory, General Electric
Company (Evendale, Ohio), Blockson
Chemical Company, Chapman Valve
Manufacturing Company, United
Nuclear Corporation (Hematite,
Missouri), Hanger 481 at Kirtland Air
Force Base, Nevada Test Site, and
Westinghouse Electric Corportation
(Bloomfield, New Jersey); SEC Petition
Status Updates; Subcommittee and
Work Group Reports; Board Working
Time; and Conflict of Interest
Requirements.
The agenda is subject to change as
priorities dictate.
In the event an individual cannot
attend, written comments may be
submitted in accordance with the
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3911
redaction policy provided below. Any
written comments received will be
provided at the meeting and should be
submitted to the contact person below
well in advance of the meeting.
Policy on Redaction of Board Meeting
Transcripts (Public Comment), (1) If a
person making a comment gives his or
her name, no attempt will be made to
redact that name. (2) NIOSH will take
reasonable steps to ensure that
individuals making public comment are
aware of the fact that their comments
(including their name, if provided) will
appear in a transcript of the meeting
posted on a public Web site. Such
reasonable steps include: (a) A
statement read at the start of each public
comment period stating that transcripts
will be posted and names of speakers
will not be redacted; (b) A printed copy
of the statement mentioned in (a) above
will be displayed on the table where
individuals sign up to make public
comment; (c) A statement such as
outlined in (a) above will also appear
with the agenda for a Board Meeting
when it is posted on the NIOSH Web
site; (d) A statement such as in (a) above
will appear in the Federal Register
Notice that announces Board and
Subcommittee meetings. (3) If an
individual, in making a statement,
reveals personal information (e.g.,
medical information) about themselves,
that information will not usually be
redacted. The NIOSH FOIA coordinator
will, however, review such revelations
in accordance with the Freedom of
Information Act and the Federal
Advisory Committee Act and if deemed
appropriate, will redact such
information. (4) All disclosures of
information concerning third parties
will be redacted. (5) If it comes to the
attention of the DFO that an individual
wishes to share information with the
Board but objects to doing so in a public
forum, the DFO will work with that
individual, in accordance with the
Federal Advisory Committee Act, to
find a way that the Board can hear such
comments.
Contact Person for More Information:
Theodore Katz, M.P.A., Executive
Secretary, NIOSH, CDC, 1600 Clifton
Road, MS E–20, Atlanta, GA 30333,
Telephone (513) 533–6800, Toll Free
1(800) CDC–INFO, E-mail ocas@cdc.gov.
The Director, Management Analysis
and Services Office, has been delegated
the authority to sign Federal Register
Notices pertaining to announcements of
meetings and other committee
management activities, for both CDC
and the Agency for Toxic Substances
and Disease Registry.
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]]>Agencies
[Federal Register Volume 75, Number 15 (Monday, January 25, 2010)]
[Notices]
[Pages 3908-3911]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-1158]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research and Quality, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of
Management and Budget (OMB) approve the proposed information collection
project: ``Collection of Information for Agency for Healthcare Research
and Quality's (AHRQ) Consumer Assessment of Healthcare Providers and
Systems (CAHPS) Health Plan Survey Comparative Database.'' In
accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-3520, AHRQ
invites the public to comment on this proposed information collection.
DATES: Comments on this notice must be received by March 26, 2010.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by e-mail at
doris.lefkowitz@AHRQ.hhs.gov.
Copies of the proposed collection plans, data collection
instruments, and specific details on the estimated burden can be
obtained from the AHRQ Reports Clearance Officer.
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by e-mail at
doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
Collection of Information for Agency for Healthcare Research and
Quality's (AHRQ) Consumer Assessment of Healthcare Providers and
Systems (CAHPS) Health Plan Survey Comparative Database.
[[Page 3909]]
The Agency for Healthcare Research and Quality (AHRQ) requests that
the Office of Management and Budget (OMB) approve, under the Paperwork
Reduction Act of 1995, AHRQ's collection of information for the AHRQ
Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Database for Health Plans. The CAHPS Health Plan Database consists of
data from the AHRQ CAHPS Health Plan Survey. Health plans in the U.S.
are asked to voluntarily submit data from the survey to AHRQ, through
its contractor, Westat. The CAHPS Database was developed by AHRQ in
1998 in response to requests from health plans, purchasers, and the
Centers for Medicare & Medicaid Services (CMS) to provide comparative
data to support public reporting of health plan ratings, health plan
accreditation and quality improvement.
The CAHPS Health Plan Survey is a tool for collecting standardized
information on enrollees' experiences with health plans and their
services. The development of the CAHPS Health Plan Survey began in
1995, when AHRQ awarded the first set of CAHPS grants to Harvard, RTI,
and RAND. In 1997 the CAHPS 1.0 survey was released by the CAHPS
Consortium. The CAHPS Consortium refers to the research organizations
involved in the development, dissemination, and support of CAHPS
products. The current Consortium includes AHRQ, CMS, RAND, Yale School
of Public Health, and Westat.
Since that time, the Consortium has clarified and updated the
survey instrument to reflect field test results; feedback from industry
experts; reports from health plan participants, data collection
vendors, and other users; and evidence from cognitive testing and focus
groups. In November 2006, the CAHPS Consortium released the latest
version of the instrument: The CAHPS Health Plan Survey 4.0. The
development of this update to the Health Plan Survey has been part of
the ``Ambulatory CAHPS (A-CAHPS) Initiative,'' which arose as a result
of extensive research conducted with users. AHRQ released the CAHPS
Health Plan Survey 4.0, along with guidance on how to customize and
administer it. The National Quality Forum endorsed the 4.0 version of
the Health Plan Survey in July 2007.
The CAHPS Health Plan Database uses data from AHRQ's standardized
CAHPS Health plan survey to provide comparative results to health care
purchasers, consumers, regulators and policy makers across the country.
The Database also provides data for AHRQ's annual National Healthcare
Quality and National Healthcare Disparities Reports. Voluntary
participants include public and private employers, State Medicaid
agencies, State Children's Health Insurance Programs (SCHIP), CMS, and
individual health plans.
The collection of information for the CAHPS Database for Health
Plans is being conducted pursuant to AHRQ's statutory authority to
conduct and support research on health care and systems for the
delivery of such care, including activities with respect to the
quality, effectiveness, efficiency, appropriateness and value of health
care services. See 42 U.S.C. 299a(a)(1).
Method of Collection
Information for the CAHPS Health Plan Database has been collected
by AHRQ through its contractor Westat on an annual basis since 1998.
Health plans are asked to voluntarily submit their data to the
comparative database in June of each year. The data are cleaned with
standardized programs, then aggregated and used to produce comparative
results for commercial (adult and child), Medicaid (adult and child),
and Medicare (adult) populations for the two most recent years. In
addition, individual participant reports are produced that display the
participating organizations' own results compared to appropriate
comparisons derived from the National, regional and product-type
distributions on a password-protected section of the online reporting
system.
The CAHPS Health Plan Database receives the data from three
sources. First, commercial health plan data is purchased by the CAHPS
Health Plan Database directly from the National Committee for Quality
Assurance (NCQA). The data is collected by NCQA from those who
participate in its accreditation program. Second, Medicare data is
provided by CMS through an agency data use agreement. The Medicare data
is collected by CMS and their contractor from beneficiaries who were
enrolled in a managed care health plan. Third, Medicaid data is
collected by the CAHPS Health Plan Database. Medicaid agencies and
their vendors directly submit their Medicaid health plan survey data to
the CAPHS Health Plan Database through an online data submission
system. Data submitted by Medicaid plans are compiled along with the
data received from CMS and NCQA to comprise the CAHPS Health Plan
Survey comparative database.
Estimated Annual Respondent Burden
Each year State Medicaid agencies and individual health plans
decide whether to participate in the database and prepare their
materials and dataset for submission to the CAHPS Health Plan Database.
Participating organizations are typically State Medicaid agencies with
multiple health plans. However, individual health plans are also
encouraged to submit their data to the CAHPS Database. The number of
data submissions per registrant varies from participant to participant
and year to year because some participants submit data for multiple
health plans, while others may only submit survey data for one plan.
Each organization that decides to participate in the database must
have their POC complete a registration form providing their contact
information for access to the on-line data submission system, sign and
submit a data use agreement (DUA), and provide health plan
characteristics such as health plan name, product type, type of
population surveyed, health plan state, and plan name to appear in the
reporting of their results.
Each vendor that submits files on behalf of a Medicaid agency or
individual health plan must also complete the registration form in
order to obtain access to the on-line submission system. The vendor, on
behalf of their client, may also complete additional information about
survey administration (CAHPS survey version used, mode of survey
administration, total enrollment count, description of how the sample
was selected), submit a copy of the questionnaire used, and submit one
data file per health plan. Commercial health plan data is received
directly from NCQA. Medicare health plan data is received from CMS.
The burden hours and costs below pertain only to the collection of
Medicaid data from State Medicaid agencies and individual Medicaid
health plans because those are the only entities that submit data
through the data submission process (other data are obtained directly
from NCQA and CMS as noted earlier in Section 2). In 2009, a total of
60 participants, representing 45 individual organizations and 15
vendors, submitted data for 244 health plans (an average of about 4
health plans per participant).
Exhibits 1 and 2 are based on the estimated number of individual
participants (participating organizations and/or vendors) who will
complete the database submission steps and forms in the coming years,
and is not based on the total number of health plans that are
submitted. The number of respondents and burden hours are based on an
estimated slight increase in the number of participants to 70 in 2010
and 2011.
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In Exhibit 1, the 70 participants that will complete the
registration form and submit information to the CAHPS Health Plan
Database are a combination of an estimated 50 State Medicaid agencies
and individual health plans, and 20 estimated vendors. The 50 State
Medicaid agencies or individual health plans will sign and submit a
DUA. Vendors do not sign or submit DUAs. Health plan information and
data files are submitted for each health plan. Exhibit 1 shows an
estimated total of 280 health plans (70 estimated participants with 4
health plans per participant). The total burden hours for completing
the registration, DUA and data submission process are estimated to be
722 hours.
Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of Number of
Form name respondents/ responses per Hours per Total burden
POCS POC response hours
----------------------------------------------------------------------------------------------------------------
Registration Form and Data Submission *......... 70 1 7.6 532
Data Use Agreement **........................... 50 1 1 50
Health Plan Information ***..................... 70 4 30/60 140
---------------------------------------------------------------
Total....................................... 190 NA NA 722
----------------------------------------------------------------------------------------------------------------
* The online Registration Form requires about 5 minutes to complete; however, over 7 hours is required to plan/
prepare for the data submission. This includes the amount of time the participating organization, and others
(CEO, lawyer, vendor) typically spend deciding whether to participate in the database and preparing their
materials and dataset for submission to the CAHPS Health Plan Database and performing the submission.
** The Data Use Agreement requires about 3 minutes to complete; however, about 57 minutes is required for the
participating organization to review the agreement prior to signing. This includes the review by the
organization's CEO or legal department.
*** A few health plans may submit their data directly; however, most health plan data will be submitted by the
POC.
Exhibit 2 shows the estimated annualized cost burden based on the
respondents' time to complete the submission process. The cost burden
is estimated to be $31,046 annually.
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Average
Form name Number of Total burden hourly wage Total cost
respondents hours rate ** burden
----------------------------------------------------------------------------------------------------------------
Registration Form and Data Submission *......... 70 532 $43.00 $22,876
Data Use Agreement.............................. 50 50 43.00 2,150
Health Plan Information......................... 70 140 43.00 6,020
---------------------------------------------------------------
Total....................................... 190 722 NA 31,046
----------------------------------------------------------------------------------------------------------------
* Wage rates were calculated using the mean hourly wage based on occupational employment and wage estimates from
the Dept of Labor, Bureau of Labor Statistics' May 2008 National Industry-Specific Occupational Employment and
Wage Estimates NAICS 622000--located at https://www.bls.gov/oes/current/oes_nat.htm.
** Wage rate of $43.00 is based on the mean hourly wages for Medical and Health Services Managers. Wage rate of
$42.67 is the weighted mean hourly wage for: Medical and Health Services Managers ($42.67 x 2.6 hours =
$110.95), Lawyers ($59.98 x .5 hours = $29.99), Chief Executives ($89.16 x .5 hours = $44.58), and Computer
programmer ($35.32 x 4 hours = $141.28) [Weighted mean = ($110.95 + 29.99 + 44.58 + 141.28)/7.6 hours =
$326.80/7.6 hours = $43.00/hour].
Estimated Annual Costs to the Federal Government
Exhibit 3 shows the estimated annualized cost to the government for
developing, maintaining and managing the Health Plan Database and
analyzing the data and reporting results. The cost is estimated to be
$260,000 annually. Annualized costs for collecting and processing the
CAHPS Health Plan Database are based upon 10 years of historical
project costs. Start-up costs were present in the early years of the
database only.
Exhibit 3--Estimated Annualized Cost
------------------------------------------------------------------------
Annualized
Cost component cost
------------------------------------------------------------------------
Database Maintenance........................................ $50,000
Data Submission............................................. 100,000
Data Analysis and Reporting................................. 110,000
-----------
Total..................................................... 260,000
------------------------------------------------------------------------
Request for Comments
In accordance with the above-cited Paperwork Reduction Act
legislation, comments on AHRQ's information collection are requested
with regard to any of the following: (a) Whether the proposed
collection of information is necessary for the proper performance of
AHRQ healthcare research and healthcare information dissemination
functions, including whether the information will have practical
utility; (b) the accuracy of AHRQ's estimate of burden (including hours
and costs) of the proposed collection(s) of information; (c) ways to
enhance the quality, utility, and clarity of the information to be
collected; and (d) ways to minimize the burden of the collection of
information upon the respondents, including the use of automated
collection techniques or other forms of information technology.
Comments submitted in response to this notice will be summarized
and included in the Agency's subsequent request for OMB approval of the
proposed information collection. All comments will become a matter of
public record.
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Dated: January 11, 2010.
Carolyn M. Clancy,
Director.
[FR Doc. 2010-1158 Filed 1-22-10; 8:45 am]
BILLING CODE 4160-90-M
