Agency Information Collection Activities: Proposed Collection; Comment Request, 60741-60744 [2017-27605]

Download as PDF Federal Register / Vol. 82, No. 245 / Friday, December 22, 2017 / Notices DEPARTMENT OF HEALTH AND HUMAN SERVICES [FR Doc. 2017–27629 Filed 12–21–17; 8:45 am] BILLING CODE 8070–01–C Agency for Healthcare Research and Quality FEDERAL MARITIME COMMISSION Agency Information Collection Activities: Proposed Collection; Comment Request Notice of Agreement Filed sradovich on DSK3GMQ082PROD with NOTICES The Commission hereby gives notice of the filing of the following agreement under the Shipping Act of 1984. Interested parties may submit comments on the agreement to the Secretary, Federal Maritime Commission, Washington, DC 20573, within twelve days of the date this notice appears in the Federal Register. A copy of the agreement is available through the Commission’s website (www.fmc.gov) or by contacting the Office of Agreements at (202) 523–5793 or tradeanalysis@ fmc.gov. Agreement No.: 012439–002. Title: THE Alliance Agreement. Parties: Hapag-Lloyd AG and HapagLloyd USA LLC (acting as one party); Kawasaki Kisen Kaisha, Ltd.; Mitsui O.S.K. Lines, Ltd.; Nippon Yusen Kaisha; and Yang Ming Marine Transport Corp and Yang Ming (UK) Ltd. (acting as one party). Filing Party: Joshua Stein, Cozen O’Conner, 1200 Nineteenth Street NW, Washington, DC 20036. Synopsis: The Amendment revises the Agreement to provide for the transition that will occur following the acquisition of the assets of the container liner operations of Kawasaki Kisen Kaisha, Ltd.; Mitsui O.S.K. Lines, Ltd.; and Nippon Yusen Kaisha by a new company known as Ocean Network Express Pte. Ltd. effective April 1, 2018. Ocean Network Express Pte. Ltd. is added as a party effective on the date of the transition referenced above. In addition, the Amendment adds Yang Ming (UK) Ltd. as a party (operating as a single party with Yang Ming Marine Transport Corp.) and adds Guatemala and India to the geographic scope of the Agreement. By Order of the Federal Maritime Commission. Dated: December 19, 2017. Rachel E. Dickon, Assistant Secretary. [FR Doc. 2017–27640 Filed 12–21–17; 8:45 am] BILLING CODE 6731–AA–P VerDate Sep<11>2014 16:59 Dec 21, 2017 Jkt 244001 Agency for Healthcare Research and Quality, HHS. ACTION: Notice. AGENCY: 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 changes to the currently approved information collection project: ‘‘Medical Expenditure Panel Survey (MEPS) Household Component and the MEPS Medical Provider Component.’’ DATES: Comments on this notice must be received by February 20, 2018. 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 changes to questions asked of household respondents, data collection instruments, collection plans, 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 email at doris.lefkowitz@AHRQ.hhs.gov. SUPPLEMENTARY INFORMATION: SUMMARY: Proposed Project Medical Expenditure Panel Survey (MEPS) Household Component (HC) In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501–3521, AHRQ invites the public to comment on this proposed information collection. For over thirty years, results from the MEPS and its predecessor surveys (the 1977 National Medical Care Expenditure Survey, the 1980 National Medical Care Utilization and Expenditure Survey and the 1987 National Medical Expenditure Survey) have been used by OMB, DHHS, Congress and a wide number of health services researchers to analyze health care use, expenses and health policy. Major changes continue to take place in the health care delivery system. The MEPS is needed to provide information about the current state of the health care system as well as to track changes over time. The MEPS permits annual estimates of use of health care and PO 00000 Frm 00046 Fmt 4703 Sfmt 4703 60741 expenditures and sources of payment for that health care. It also permits tracking individual change in employment, income, health insurance and health status over two years. The use of the National Health Interview Survey (NHIS) as a sampling frame expands the MEPS analytic capacity by providing another data point for comparisons over time. Households selected for participation in the MEPS–HC are interviewed five times in person. These rounds of interviewing are spaced about 5 months apart. The interview will take place with a family respondent who will report for him/herself and for other family members. The only change to the MEPS–HC from the previous OMB clearance is an update to the existing Adult SelfAdministered Questionnaire (SAQ). The MEPS–HC has the following goal: D To provide nationally representative estimates for the U.S. civilian noninstitutionalized population for: • Health care use, expenditures, sources of payment • health insurance coverage Medical Expenditure Panel Survey (MEPS) Medical Provider Component (MPC) The MEPS–MPC will contact medical providers (hospitals, physicians, home health agencies and institutions) identified by household respondents in the MEPS–HC as sources of medical care for the time period covered by the interview, and all pharmacies providing prescription drugs to household members during the covered time period. The MEPS–MPC is not designed to yield national estimates as a standalone survey. The sample is designed to target the types of individuals and providers for whom household reported expenditure data was expected to be insufficient. For example, Medicaid enrollees are targeted for inclusion in the MEPS–MPC because this group is expected to have limited information about payments for their medical care. The MEPS–MPC collects event level data about medical care received by sampled persons during the relevant time period. The data collected from medical providers include: • Dates on which medical encounters occurred during the reference period • Data on the medical content of each encounter, including ICD–9 (or ICD– 10) and CPT–4 codes • Data on the charges associated with each encounter, such as the sources paying for the medical care-including the patient/family, public sources, and private insurance, and amounts paid by each source E:\FR\FM\22DEN1.SGM 22DEN1 60742 Federal Register / Vol. 82, No. 245 / Friday, December 22, 2017 / Notices Data collected from pharmacies include: • Date on which a prescription was filled • National drug code (NDC) or prescription name, strength and form • Quantity • Payments, by source The MEPS–MPC has the following goal: • To serve as an imputation source for and to supplement/replace household reported expenditure and source of payment information. This data will supplement, replace and verify information provided by household respondents about the charges, payments, and sources of payment associated with specific health care encounters. There are no changes to the MEPS– MPC from the previous OMB clearance. This study is being conducted by AHRQ through its contractors, Westat and RTI International, pursuant to AHRQ’s statutory authority to conduct and support research on health care and on systems for the delivery of such care, including activities with respect to the cost and use of health care services and with respect to health statistics and surveys. 42 U.S.C. 299a(a)(3) and (8); 42 U.S.C. 299b–2. sradovich on DSK3GMQ082PROD with NOTICES Method of Collection To achieve the goals of the MEPS–HC the following data collections are implemented: 1. Household Component Core Instrument. The core instrument collects data about persons in sample households. Topical areas asked in each round of interviewing include condition enumeration, health status, health care utilization including prescribed medicines, expense and payment, employment, and health insurance. Other topical areas that are asked only once a year include access to care, income, assets, satisfaction with health plans and providers, children’s health, and adult preventive care. While many of the questions are asked about the entire reporting unit, which is typically a family, only one person normally provides this information. All sections of the current core instrument are available on the AHRQ website at http:// meps.ahrq.gov/mepsweb/survey_comp/ survey_questionnaires.jsp. 2. Adult Self Administered Questionnaire. A brief self-administered questionnaire (SAQ) will be used to collect self-reported (rather than through household proxy) information on health status, health opinions and satisfaction with health care for adults 18 and older. The health status items are VerDate Sep<11>2014 16:59 Dec 21, 2017 Jkt 244001 from the Veterans Rand 12-item health survey (VR–12). Additionally there are questions addressing adult preventive care for both males and females. This questionnaire has changed from the previous OMB clearance. 3. Diabetes Care SAQ. A brief selfadministered, paper-and-pencil questionnaire on the quality of diabetes care is administered once a year (during round 3 and 5) to persons identified as having diabetes. Included are questions about the number of times the respondent reported having a hemoglobin A1c blood test, whether the respondent reported having his or her feet checked for sores or irritations, whether the respondent reported having an eye exam in which the pupils were dilated, the last time the respondent had his or her blood cholesterol checked and whether the diabetes has caused kidney or eye problems. Respondents are also asked if their diabetes is being treated with diet, oral medications or insulin. See http://meps.ahrq.gov/mepsweb/ survey_comp/survey.jsp#supplemental. 4. Authorization forms for the MEPS– MPC Provider and Pharmacy Survey. As in previous panels of the MEPS, we will ask respondents for authorization to obtain supplemental information from their medical providers (hospitals, physicians, home health agencies and institutions) and pharmacies. See http:// meps.ahrq.gov/mepsweb/survey_comp/ survey.jsp#MPC_AF for the pharmacy and provider authorization forms. 5. MEPS Validation Interview. Each interviewer is required to have at least 15 percent of his/her caseload validated to insure that CAPI questionnaire content was asked appropriately and procedures followed, for example the use of show cards. Validation flags are set programmatically for cases preselected by data processing staff before each round of interviewing. Home office and field management may also request that other cases be validated throughout the field period. When an interviewer fails a validation all his or her work is subject to 100 percent validation. Additionally, any case completed in less than 30 minutes is validated. A validation abstract form containing selected data collected in the CAPI interview is generated and used by the validator to guide the validation interview. To achieve the goal of the MEPS–MPC the following data collections are implemented: 1. MPC Contact Guide/Screening Call. An initial screening call is placed to determine the type of facility, whether the practice or facility is in scope for the MEPS–MPC, the appropriate MEPS– MPC respondent and some details about PO 00000 Frm 00047 Fmt 4703 Sfmt 4703 the organization and availability of medical records and billing at the practice/facility. All hospitals, physician offices, home health agencies, institutions and pharmacies are screened by telephone using a unique screening instrument, except for the two home care provider types which use the same screening form; see http:// meps.ahrq.gov/mepsweb/survey_comp/ survey.jsp#MPC_CG. 2. Home Care Provider Questionnaire for Health Care Providers. This questionnaire is used to collect data from home health care agencies which provide medical care services to household respondents. Information collected includes type of personnel providing care, hours or visits provided per month, and the charges and payments for services received. See http://meps.ahrq.gov/mepsweb/survey_ comp/survey.jsp#MPC. 3. Home Care Provider Questionnaire for Non-Health Care Providers. This questionnaire is used to collect information about services provided in the home by non-health care workers to household respondents because of a medical condition; for example, cleaning or yard work, transportation, shopping, or child care. See http:// meps.ahrq.gov/mepsweb/survey_comp/ survey.jsp#MPC. 4. Medical Event Questionnaire for Office-Based Providers. This questionnaire is for office-based physicians, including doctors of medicine (MDs) and osteopathy (DOs), as well as providers practicing under the direction or supervision of an MD or DO (e.g., physician assistants and nurse practitioners working in clinics). Providers of care in private offices as well as staff model HMOs are included. See http://meps.ahrq.gov/mepsweb/ survey_comp/survey.jsp#MPC. 5. Medical Event Questionnaire for Separately Billing Doctors. This questionnaire collects information from physicians identified by hospitals (during the Hospital Event data collection) as providing care to sampled persons during the course of inpatient, outpatient department or emergency room care, but who bill separately from the hospital. See http://meps.ahrq.gov/ mepsweb/survey_comp/survey.jsp#MPC. 6. Hospital Event Questionnaire. This questionnaire is used to collect information about hospital events, including inpatient stays, outpatient department, and emergency room visits. Hospital data are collected not only from the billing department, but from medical records and administrative records departments as well. Medical records departments are contacted to determine the names of all the doctors E:\FR\FM\22DEN1.SGM 22DEN1 60743 Federal Register / Vol. 82, No. 245 / Friday, December 22, 2017 / Notices who treated the patient during a stay or visit. In many cases, the hospital administrative office also has to be contacted to determine whether the doctors identified by medical records billed separately from the hospital itself; the doctors that do bill separately from the hospital will be contacted as part of the Medical Event Questionnaire for Separately Billing Doctors. HMOs are included in this provider type. See http://meps.ahrq.gov/mepsweb/survey_ comp/survey.jsp#MPC. 7. Institutions Event Questionnaire. This questionnaire is used to collect information about institution events, including nursing homes, rehabilitation facilities and skilled nursing facilities. Institution data are collected not only from the billing department, but from medical records and administrative records departments as well. Medical records departments are contacted to determine the names of all the doctors who treated the patient during a stay. In many cases, the institution administrative office also has to be contacted to determine whether the doctors identified by medical records billed separately from the institution itself. See http://meps.ahrq.gov/ mepsweb/survey_comp/ survey.jsp#MPC). 8. Pharmacy Data Collection Questionnaire. This questionnaire requests the national drug code (NDC) and when that is not available the prescription name, date prescription was filled, payments by source, prescription strength and form (when the NDC is not available), quantity, and person for whom the prescription was filled. When the NDC is available, we do not ask for prescription name, strength or form because that information is embedded in the NDC; this reduces burden on the respondent. Most pharmacies have the requested information available in electronic format and respond by providing a computer generated printout of the patient’s prescription information. If the computerized form is unavailable, the pharmacy can report their data to a telephone interviewer. Pharmacies are also able to provide a CD–ROM with the requested information if that is preferred. HMOs are included in this provider type. See http:// meps.ahrq.gov/mepsweb/survey_comp/ survey.jsp#MPC. 9. Medical Organizations Survey Questionnaire. This questionnaire will collect essential information on important features of the staffing, organization, policies, and financing for identified usual source of office based care providers. This additional data are linked to MEPS sample respondents to enable analyses at the person-level using characteristics of provider practices. Dentists, optometrists, psychologists, podiatrists, chiropractors, and others not providing care under the supervision of a MD or DO are considered out of scope for the MEPS– MPC. Estimated Annual Respondent Burden Exhibit 1 shows the estimated annualized burden hours for the respondents’ time to participate in the MEPS–HC and the MEPS–MPC. The MEPS–HC Core Interview will be completed by 15,093* (see note below Exhibit 1) ‘‘family level’’ respondents, also referred to as RU respondents. Since the MEPS–HC consists of 5 rounds of interviewing covering a full two years of data, the annual average number of responses per respondent is 2.5 responses per year. The MEPS–HC core requires an average response time of 92 minutes to administer. The Adult SAQ will be completed once a year by each person in the RU that is 18 years old and older, an estimated 28,254 persons. The Adult SAQ requires an average of 7 minutes to complete. The Diabetes care SAQ will be completed once a year by each person in the RU identified as having diabetes, an estimated 2,345 persons, and takes about 3 minutes to complete. The authorization form for the MEPS–MPC Provider Survey will be completed once for each medical provider seen by any RU member. The 14,489 RUs in the MEPS–HC will complete an average of 5.4 forms, which require about 3 minutes each to complete. The authorization form for the MEPS–MPC Pharmacy Survey will be completed once for each pharmacy for any RU member who has obtained a prescription medication. RUs will complete an average of 3.1 forms, which take about 3 minutes to complete. About one third of all interviewed RUs will complete a validation interview as part of the MEPS–HC quality control, which takes an average of 5 minutes to complete. The total annual burden hours for the MEPS–HC are estimated to be 67,826 hours. All medical providers and pharmacies included in the MEPS–MPC will receive a screening call and the MEPS–MPC uses 7 different questionnaires; 6 for medical providers and 1 for pharmacies. Each questionnaire is relatively short and requires 2 to 15 minutes to complete. The total annual burden hours for the MEPS–MPC are estimated to be 18,876 hours. The total annual burden for the MEPS–HC and MPC is estimated to be 86,702 hours. Exhibit 2 shows the estimated annual cost burden associated with the respondents’ time to participate in this information collection. The annual cost burden for the MEPS–HC is estimated to be $1,618,328; the annual cost burden for the MEPS–MPC is estimated to be $316,532. The total annual cost burden for the MEPS–HC and MPC is estimated to be $1,934,860. EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS Number of respondents sradovich on DSK3GMQ082PROD with NOTICES Form name MEPS–HC: MEPS–HC Core Interview ........................................................................ Adult SAQ ................................................................................................. Diabetes care SAQ ................................................................................... Authorization form for the MEPS–MPC Provider Survey ......................... Authorization form for the MEPS–MPC Pharmacy Survey ...................... MEPS–HC Validation Interview ................................................................ Subtotal for the MEPS–HC ............................................................... MEPS–MPC/MOS: MPC Contact Guide/Screening Call ** ...................................................... Home care for health care providers questionnaire ................................. Home care for non-health care providers questionnaire .......................... Office-based providers questionnaire ....................................................... VerDate Sep<11>2014 16:59 Dec 21, 2017 Jkt 244001 PO 00000 Frm 00048 Fmt 4703 Sfmt 4703 Number of responses per respondent Hours per response Total burden hours * 15,093 28,254 2,345 14,489 14,489 4,781 2.5 1 1 5.4 3.1 1 92/60 7/60 3/60 3/60 3/60 5/60 57,857 3,296 117 3,912 2,246 398 79,451 Na na 67,826 35,222 532 25 11,785 1 1.49 1 1.44 2/60 9/60 11/60 10/60 1,174 119 5 2,828 E:\FR\FM\22DEN1.SGM 22DEN1 60744 Federal Register / Vol. 82, No. 245 / Friday, December 22, 2017 / Notices EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS—Continued Number of respondents Form name Number of responses per respondent Hours per response Total burden hours Separately billing doctors questionnaire ................................................... Hospitals questionnaire ............................................................................ Institutions (non-hospital) questionnaire ................................................... Pharmacies questionnaire ........................................................................ Medical Organizations Survey questionnaire ........................................... 12,693 5,077 117 4,993 6,000 3.43 3.51 2.03 4.44 1 13/60 9/60 9/60 3/60 15/60 9,433 2,673 36 1,108 1,500 Subtotal for the MEPS–MPC ............................................................. 76,444 na na 18,876 Grand Total ................................................................................ 155,895 na na 86,702 * While the expected number of responding units for the annual estimates is 14,489, it is necessary to adjust for survey attrition of initial respondents by a factor of 0.96 (15,093 = 14,489/0.96). ** There are 6 different contact guides; one for office based, separately billing doctor, hospital, institution, and pharmacy provider types, and the two home care provider types use the same contact guide. EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN Number of respondents Form name MEPS–HC: MEPS–HC Core Interview ........................................................................ Adult SAQ ................................................................................................. Diabetes care SAQ ................................................................................... Authorization forms for the MEPS–MPC Provider Survey ....................... Authorization form for the MEPS–MPC Pharmacy Survey ...................... MEPS–HC Validation Interview ................................................................ Total burden hours Average hourly wage rate Total cost burden 15,093 28,254 2,345 14,489 14,489 4,781 57,857 3,296 117 3,912 2,246 398 * $23.86 * 23.86 * 23.86 * 23.86 * 23.86 * 23.86 $1,380,468 78,643 2,792 93,340 53,590 9,496 Subtotal for the MEPS–HC ............................................................... MEPS–MPC/MOS: MPC Contact Guide/Screening Call ......................................................... Home care for health care providers questionnaire ................................. Home care for non-health care providers questionnaire .......................... Office-based providers questionnaire ....................................................... Separately billing doctors questionnaire ................................................... Hospitals questionnaire ............................................................................ Institutions (non-hospital) questionnaire ................................................... Pharmacies questionnaire ........................................................................ Medical Organizations Survey questionnaire ........................................... 79,451 67,826 Na 1,618,328 35,222 532 25 11,785 12,693 5,077 117 4,993 6,000 1,174 119 5 2,828 9,433 2,673 36 1,108 1,500 ** 16.85 ** 16.85 ** 16.85 ** 16.85 ** 16.85 ** 16.85 ** 16.85 *** 15.47 ** 16.85 19,782 2,005 84 47,652 158,946 45,040 607 17,141 25,275 Subtotal for the MEPS–MPC ............................................................. 76,444 18,876 na 316,532 Grand Total ................................................................................ 155,895 86,073 na 1,934,860 * Mean hourly wage for All Occupations (00–0000). ** Mean hourly wage for Medical Secretaries (43–6013). *** Mean hourly wage for Pharmacy Technicians (29–2052). Occupational Employment Statistics, May 2016 National Occupational Employment and Wage Estimates United States, U.S. Department of Labor, Bureau of Labor Statistics. http://www.bls.gov/oes/current/oes_nat.htm#b29-0000. sradovich on DSK3GMQ082PROD with NOTICES Request for Comments In accordance with the Paperwork Reduction Act, 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 VerDate Sep<11>2014 16:59 Dec 21, 2017 Jkt 244001 (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. [FR Doc. 2017–27605 Filed 12–21–17; 8:45 am] BILLING CODE 4160–90–P Frm 00049 Fmt 4703 Centers for Medicare & Medicaid Services [Document Identifier: CMS–R–262] Agency Information Collection Activities: Submission for OMB Review; Comment Request ACTION: Notice; partial withdrawal. On Wednesday, December 13, 2017, the Centers for Medicare & Medicaid Services (CMS) published a notice document entitled, ‘‘Agency Information Collection Activities: SUMMARY: Sharon B. Arnold, Deputy Director. PO 00000 DEPARTMENT OF HEALTH AND HUMAN SERVICES Sfmt 4703 E:\FR\FM\22DEN1.SGM 22DEN1

Agencies

[Federal Register Volume 82, Number 245 (Friday, December 22, 2017)]
[Notices]
[Pages 60741-60744]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-27605]


=======================================================================
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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 changes to the 
currently approved information collection project: ``Medical 
Expenditure Panel Survey (MEPS) Household Component and the MEPS 
Medical Provider Component.''

DATES: Comments on this notice must be received by February 20, 2018.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by email at 
[email protected].
    Copies of the proposed changes to questions asked of household 
respondents, data collection instruments, collection plans, 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 email at 
[email protected].

SUPPLEMENTARY INFORMATION:

Proposed Project

Medical Expenditure Panel Survey (MEPS) Household Component (HC)

    In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-
3521, AHRQ invites the public to comment on this proposed information 
collection. For over thirty years, results from the MEPS and its 
predecessor surveys (the 1977 National Medical Care Expenditure Survey, 
the 1980 National Medical Care Utilization and Expenditure Survey and 
the 1987 National Medical Expenditure Survey) have been used by OMB, 
DHHS, Congress and a wide number of health services researchers to 
analyze health care use, expenses and health policy.
    Major changes continue to take place in the health care delivery 
system. The MEPS is needed to provide information about the current 
state of the health care system as well as to track changes over time. 
The MEPS permits annual estimates of use of health care and 
expenditures and sources of payment for that health care. It also 
permits tracking individual change in employment, income, health 
insurance and health status over two years. The use of the National 
Health Interview Survey (NHIS) as a sampling frame expands the MEPS 
analytic capacity by providing another data point for comparisons over 
time.
    Households selected for participation in the MEPS-HC are 
interviewed five times in person. These rounds of interviewing are 
spaced about 5 months apart. The interview will take place with a 
family respondent who will report for him/herself and for other family 
members.
    The only change to the MEPS-HC from the previous OMB clearance is 
an update to the existing Adult Self-Administered Questionnaire (SAQ).
    The MEPS-HC has the following goal:

[ssquf] To provide nationally representative estimates for the U.S. 
civilian noninstitutionalized population for:
     Health care use, expenditures, sources of payment
     health insurance coverage

Medical Expenditure Panel Survey (MEPS) Medical Provider Component 
(MPC)

    The MEPS-MPC will contact medical providers (hospitals, physicians, 
home health agencies and institutions) identified by household 
respondents in the MEPS-HC as sources of medical care for the time 
period covered by the interview, and all pharmacies providing 
prescription drugs to household members during the covered time period. 
The MEPS-MPC is not designed to yield national estimates as a stand-
alone survey. The sample is designed to target the types of individuals 
and providers for whom household reported expenditure data was expected 
to be insufficient. For example, Medicaid enrollees are targeted for 
inclusion in the MEPS-MPC because this group is expected to have 
limited information about payments for their medical care.
    The MEPS-MPC collects event level data about medical care received 
by sampled persons during the relevant time period. The data collected 
from medical providers include:

 Dates on which medical encounters occurred during the 
reference period
 Data on the medical content of each encounter, including ICD-9 
(or ICD-10) and CPT-4 codes
 Data on the charges associated with each encounter, such as 
the sources paying for the medical care-including the patient/family, 
public sources, and private insurance, and amounts paid by each source


[[Page 60742]]


    Data collected from pharmacies include:

 Date on which a prescription was filled
 National drug code (NDC) or prescription name, strength and 
form
 Quantity
 Payments, by source

    The MEPS-MPC has the following goal:
     To serve as an imputation source for and to supplement/
replace household reported expenditure and source of payment 
information. This data will supplement, replace and verify information 
provided by household respondents about the charges, payments, and 
sources of payment associated with specific health care encounters.
    There are no changes to the MEPS-MPC from the previous OMB 
clearance.
    This study is being conducted by AHRQ through its contractors, 
Westat and RTI International, pursuant to AHRQ's statutory authority to 
conduct and support research on health care and on systems for the 
delivery of such care, including activities with respect to the cost 
and use of health care services and with respect to health statistics 
and surveys. 42 U.S.C. 299a(a)(3) and (8); 42 U.S.C. 299b-2.

Method of Collection

    To achieve the goals of the MEPS-HC the following data collections 
are implemented:
    1. Household Component Core Instrument. The core instrument 
collects data about persons in sample households. Topical areas asked 
in each round of interviewing include condition enumeration, health 
status, health care utilization including prescribed medicines, expense 
and payment, employment, and health insurance. Other topical areas that 
are asked only once a year include access to care, income, assets, 
satisfaction with health plans and providers, children's health, and 
adult preventive care. While many of the questions are asked about the 
entire reporting unit, which is typically a family, only one person 
normally provides this information. All sections of the current core 
instrument are available on the AHRQ website at http://meps.ahrq.gov/mepsweb/survey_comp/survey_questionnaires.jsp.
    2. Adult Self Administered Questionnaire. A brief self-administered 
questionnaire (SAQ) will be used to collect self-reported (rather than 
through household proxy) information on health status, health opinions 
and satisfaction with health care for adults 18 and older. The health 
status items are from the Veterans Rand 12-item health survey (VR-12). 
Additionally there are questions addressing adult preventive care for 
both males and females. This questionnaire has changed from the 
previous OMB clearance.
    3. Diabetes Care SAQ. A brief self-administered, paper-and-pencil 
questionnaire on the quality of diabetes care is administered once a 
year (during round 3 and 5) to persons identified as having diabetes. 
Included are questions about the number of times the respondent 
reported having a hemoglobin A1c blood test, whether the respondent 
reported having his or her feet checked for sores or irritations, 
whether the respondent reported having an eye exam in which the pupils 
were dilated, the last time the respondent had his or her blood 
cholesterol checked and whether the diabetes has caused kidney or eye 
problems. Respondents are also asked if their diabetes is being treated 
with diet, oral medications or insulin. See http://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#supplemental.
    4. Authorization forms for the MEPS-MPC Provider and Pharmacy 
Survey. As in previous panels of the MEPS, we will ask respondents for 
authorization to obtain supplemental information from their medical 
providers (hospitals, physicians, home health agencies and 
institutions) and pharmacies. See http://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC_AF for the pharmacy and provider 
authorization forms.
    5. MEPS Validation Interview. Each interviewer is required to have 
at least 15 percent of his/her caseload validated to insure that CAPI 
questionnaire content was asked appropriately and procedures followed, 
for example the use of show cards. Validation flags are set 
programmatically for cases pre-selected by data processing staff before 
each round of interviewing. Home office and field management may also 
request that other cases be validated throughout the field period. When 
an interviewer fails a validation all his or her work is subject to 100 
percent validation. Additionally, any case completed in less than 30 
minutes is validated. A validation abstract form containing selected 
data collected in the CAPI interview is generated and used by the 
validator to guide the validation interview.
    To achieve the goal of the MEPS-MPC the following data collections 
are implemented:
    1. MPC Contact Guide/Screening Call. An initial screening call is 
placed to determine the type of facility, whether the practice or 
facility is in scope for the MEPS-MPC, the appropriate MEPS-MPC 
respondent and some details about the organization and availability of 
medical records and billing at the practice/facility. All hospitals, 
physician offices, home health agencies, institutions and pharmacies 
are screened by telephone using a unique screening instrument, except 
for the two home care provider types which use the same screening form; 
see http://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC_CG.
    2. Home Care Provider Questionnaire for Health Care Providers. This 
questionnaire is used to collect data from home health care agencies 
which provide medical care services to household respondents. 
Information collected includes type of personnel providing care, hours 
or visits provided per month, and the charges and payments for services 
received. See http://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
    3. Home Care Provider Questionnaire for Non-Health Care Providers. 
This questionnaire is used to collect information about services 
provided in the home by non-health care workers to household 
respondents because of a medical condition; for example, cleaning or 
yard work, transportation, shopping, or child care. See http://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
    4. Medical Event Questionnaire for Office-Based Providers. This 
questionnaire is for office-based physicians, including doctors of 
medicine (MDs) and osteopathy (DOs), as well as providers practicing 
under the direction or supervision of an MD or DO (e.g., physician 
assistants and nurse practitioners working in clinics). Providers of 
care in private offices as well as staff model HMOs are included. See 
http://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
    5. Medical Event Questionnaire for Separately Billing Doctors. This 
questionnaire collects information from physicians identified by 
hospitals (during the Hospital Event data collection) as providing care 
to sampled persons during the course of inpatient, outpatient 
department or emergency room care, but who bill separately from the 
hospital. See http://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
    6. Hospital Event Questionnaire. This questionnaire is used to 
collect information about hospital events, including inpatient stays, 
outpatient department, and emergency room visits. Hospital data are 
collected not only from the billing department, but from medical 
records and administrative records departments as well. Medical records 
departments are contacted to determine the names of all the doctors

[[Page 60743]]

who treated the patient during a stay or visit. In many cases, the 
hospital administrative office also has to be contacted to determine 
whether the doctors identified by medical records billed separately 
from the hospital itself; the doctors that do bill separately from the 
hospital will be contacted as part of the Medical Event Questionnaire 
for Separately Billing Doctors. HMOs are included in this provider 
type. See http://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
    7. Institutions Event Questionnaire. This questionnaire is used to 
collect information about institution events, including nursing homes, 
rehabilitation facilities and skilled nursing facilities. Institution 
data are collected not only from the billing department, but from 
medical records and administrative records departments as well. Medical 
records departments are contacted to determine the names of all the 
doctors who treated the patient during a stay. In many cases, the 
institution administrative office also has to be contacted to determine 
whether the doctors identified by medical records billed separately 
from the institution itself. See http://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC).
    8. Pharmacy Data Collection Questionnaire. This questionnaire 
requests the national drug code (NDC) and when that is not available 
the prescription name, date prescription was filled, payments by 
source, prescription strength and form (when the NDC is not available), 
quantity, and person for whom the prescription was filled. When the NDC 
is available, we do not ask for prescription name, strength or form 
because that information is embedded in the NDC; this reduces burden on 
the respondent. Most pharmacies have the requested information 
available in electronic format and respond by providing a computer 
generated printout of the patient's prescription information. If the 
computerized form is unavailable, the pharmacy can report their data to 
a telephone interviewer. Pharmacies are also able to provide a CD-ROM 
with the requested information if that is preferred. HMOs are included 
in this provider type. See http://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
    9. Medical Organizations Survey Questionnaire. This questionnaire 
will collect essential information on important features of the 
staffing, organization, policies, and financing for identified usual 
source of office based care providers. This additional data are linked 
to MEPS sample respondents to enable analyses at the person-level using 
characteristics of provider practices.
    Dentists, optometrists, psychologists, podiatrists, chiropractors, 
and others not providing care under the supervision of a MD or DO are 
considered out of scope for the MEPS-MPC.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
respondents' time to participate in the MEPS-HC and the MEPS-MPC. The 
MEPS-HC Core Interview will be completed by 15,093* (see note below 
Exhibit 1) ``family level'' respondents, also referred to as RU 
respondents. Since the MEPS-HC consists of 5 rounds of interviewing 
covering a full two years of data, the annual average number of 
responses per respondent is 2.5 responses per year. The MEPS-HC core 
requires an average response time of 92 minutes to administer. The 
Adult SAQ will be completed once a year by each person in the RU that 
is 18 years old and older, an estimated 28,254 persons. The Adult SAQ 
requires an average of 7 minutes to complete. The Diabetes care SAQ 
will be completed once a year by each person in the RU identified as 
having diabetes, an estimated 2,345 persons, and takes about 3 minutes 
to complete. The authorization form for the MEPS-MPC Provider Survey 
will be completed once for each medical provider seen by any RU member. 
The 14,489 RUs in the MEPS-HC will complete an average of 5.4 forms, 
which require about 3 minutes each to complete. The authorization form 
for the MEPS-MPC Pharmacy Survey will be completed once for each 
pharmacy for any RU member who has obtained a prescription medication. 
RUs will complete an average of 3.1 forms, which take about 3 minutes 
to complete. About one third of all interviewed RUs will complete a 
validation interview as part of the MEPS-HC quality control, which 
takes an average of 5 minutes to complete. The total annual burden 
hours for the MEPS-HC are estimated to be 67,826 hours.
    All medical providers and pharmacies included in the MEPS-MPC will 
receive a screening call and the MEPS-MPC uses 7 different 
questionnaires; 6 for medical providers and 1 for pharmacies. Each 
questionnaire is relatively short and requires 2 to 15 minutes to 
complete. The total annual burden hours for the MEPS-MPC are estimated 
to be 18,876 hours. The total annual burden for the MEPS-HC and MPC is 
estimated to be 86,702 hours.
    Exhibit 2 shows the estimated annual cost burden associated with 
the respondents' time to participate in this information collection. 
The annual cost burden for the MEPS-HC is estimated to be $1,618,328; 
the annual cost burden for the MEPS-MPC is estimated to be $316,532. 
The total annual cost burden for the MEPS-HC and MPC is estimated to be 
$1,934,860.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of
                    Form name                        Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
MEPS-HC:
    MEPS-HC Core Interview......................        * 15,093             2.5           92/60          57,857
    Adult SAQ...................................          28,254               1            7/60           3,296
    Diabetes care SAQ...........................           2,345               1            3/60             117
    Authorization form for the MEPS-MPC Provider          14,489             5.4            3/60           3,912
     Survey.....................................
    Authorization form for the MEPS-MPC Pharmacy          14,489             3.1            3/60           2,246
     Survey.....................................
    MEPS-HC Validation Interview................           4,781               1            5/60             398
                                                 ---------------------------------------------------------------
        Subtotal for the MEPS-HC................          79,451              Na              na          67,826
MEPS-MPC/MOS:
    MPC Contact Guide/Screening Call **.........          35,222               1            2/60           1,174
    Home care for health care providers                      532            1.49            9/60             119
     questionnaire..............................
    Home care for non-health care providers                   25               1           11/60               5
     questionnaire..............................
    Office-based providers questionnaire........          11,785            1.44           10/60           2,828

[[Page 60744]]

 
    Separately billing doctors questionnaire....          12,693            3.43           13/60           9,433
    Hospitals questionnaire.....................           5,077            3.51            9/60           2,673
    Institutions (non-hospital) questionnaire...             117            2.03            9/60              36
    Pharmacies questionnaire....................           4,993            4.44            3/60           1,108
    Medical Organizations Survey questionnaire..           6,000               1           15/60           1,500
                                                 ---------------------------------------------------------------
        Subtotal for the MEPS-MPC...............          76,444              na              na          18,876
                                                 ---------------------------------------------------------------
            Grand Total.........................         155,895              na              na          86,702
----------------------------------------------------------------------------------------------------------------
* While the expected number of responding units for the annual estimates is 14,489, it is necessary to adjust
  for survey attrition of initial respondents by a factor of 0.96 (15,093 = 14,489/0.96).
** There are 6 different contact guides; one for office based, separately billing doctor, hospital, institution,
  and pharmacy provider types, and the two home care provider types use the same contact guide.


                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                    Form name                        Number of     Total burden     hourly wage     Total cost
                                                    respondents        hours           rate           burden
----------------------------------------------------------------------------------------------------------------
MEPS-HC:
    MEPS-HC Core Interview......................          15,093          57,857        * $23.86      $1,380,468
    Adult SAQ...................................          28,254           3,296         * 23.86          78,643
    Diabetes care SAQ...........................           2,345             117         * 23.86           2,792
    Authorization forms for the MEPS-MPC                  14,489           3,912         * 23.86          93,340
     Provider Survey............................
    Authorization form for the MEPS-MPC Pharmacy          14,489           2,246         * 23.86          53,590
     Survey.....................................
    MEPS-HC Validation Interview................           4,781             398         * 23.86           9,496
                                                 ---------------------------------------------------------------
        Subtotal for the MEPS-HC................          79,451          67,826              Na       1,618,328
MEPS-MPC/MOS:
    MPC Contact Guide/Screening Call............          35,222           1,174        ** 16.85          19,782
    Home care for health care providers                      532             119        ** 16.85           2,005
     questionnaire..............................
    Home care for non[dash]health care providers              25               5        ** 16.85              84
     questionnaire..............................
    Office[dash]based providers questionnaire...          11,785           2,828        ** 16.85          47,652
    Separately billing doctors questionnaire....          12,693           9,433        ** 16.85         158,946
    Hospitals questionnaire.....................           5,077           2,673        ** 16.85          45,040
    Institutions (non-hospital) questionnaire...             117              36        ** 16.85             607
    Pharmacies questionnaire....................           4,993           1,108       *** 15.47          17,141
    Medical Organizations Survey questionnaire..           6,000           1,500        ** 16.85          25,275
                                                 ---------------------------------------------------------------
        Subtotal for the MEPS-MPC...............          76,444          18,876              na         316,532
                                                 ---------------------------------------------------------------
            Grand Total.........................         155,895          86,073              na       1,934,860
----------------------------------------------------------------------------------------------------------------
* Mean hourly wage for All Occupations (00-0000).
** Mean hourly wage for Medical Secretaries (43-6013).
*** Mean hourly wage for Pharmacy Technicians (29-2052).
Occupational Employment Statistics, May 2016 National Occupational Employment and Wage Estimates United States,
  U.S. Department of Labor, Bureau of Labor Statistics. http://www.bls.gov/oes/current/oes_nat.htm#b29-0000.

Request for Comments

    In accordance with the Paperwork Reduction Act, 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.

Sharon B. Arnold,
Deputy Director.
[FR Doc. 2017-27605 Filed 12-21-17; 8:45 am]
BILLING CODE 4160-90-P