Agency Information Collection Activities: Proposed Collection; Comment Request, 18544-18548 [2019-08765]
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18544
Federal Register / Vol. 84, No. 84 / Wednesday, May 1, 2019 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, HHS.
AGENCY:
ACTION:
Notice.
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
updates to the currently approved
information collection project: ‘‘Medical
Expenditure Panel Survey (MEPS)
Household Component.’’
SUMMARY:
Comments on this notice must be
received by July 1, 2019.
DATES:
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.
ADDRESSES:
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
emails at doris.lefkowitz@
AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
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Proposed Project
In accordance with the Paperwork
Reduction Act, 44 U.S.C. 3501–3521,
AHRQ invites the public to comment on
this proposed information collection.
This request is for an update to the
previously submitted and OMBapproved clearance for the data
collections of the Household and
Medical Provider Components of the
Medical Expenditure Panel Survey
(MEPS). The previous OMB clearance
request for the MEPS was approved
November, 2018, with an expiration
date of November 30, 2021. We propose
updating the MEPS –HC by (1) adding
a self-administered questionnaire
focusing on mental health, (2) collecting
a health insurance cost-sharing
document and (3) implementing a pilot
study to evaluate the potential
effectiveness of including a sample of
NHIS nonrespondents in future MEPS
panels as a strategy to improve the
overall MEPS response rate.
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Medical Expenditure Panel Survey
(MEPS) Household Component and the
MEPS Medical Provider Component
• Household Component: A sample of
households participating in the National
Health Interview Survey (NHIS) in the
prior calendar year are interviewed 5
times over a 2 and one half (2.5) year
period. These 5 interviews yield two
years of information on use of, and
expenditures for, health care, sources of
payment for that health care, insurance
status, employment, health status and
health care quality.
• Medical Provider Component: The
MEPS–MPC collects information from
medical and financial records
maintained by hospitals, physicians,
pharmacies and home health agencies
named as sources of care by household
respondents.
• Insurance Component (MEPS–IC):
The MEPS–IC collects information on
establishment characteristics, insurance
offerings and premiums from
employers. The MEPS–IC is conducted
by the Census Bureau for AHRQ and is
cleared separately.
The MEPS is a multi-purpose survey.
In addition to collecting data to yield
annual estimates for a variety of
measures related to health care use and
expenditures, MEPS also provides
estimates of measures related to health
status, consumer assessment of health
care, health insurance coverage,
demographic characteristics,
employment and access to health care
indicators. Estimates can be provided
for individuals, families and population
subgroups of interest. Data obtained in
this study are used to provide, among
others, the following national estimates:
• Annual estimates of health care use
and expenditures for persons and
families
• annual estimates of sources of
payment for health care utilizations,
including public programs such as
Medicare and Medicaid, private
insurance, and out of pocket
payments
• annual estimates of health care use,
expenditures and sources of payment
of persons and families by type of
utilization including inpatient stay,
ambulatory care, home health, dental
care and prescribed medications
• the number and characteristics of the
population eligible for public
programs including the use of services
and expenditures of the population(s)
eligible for benefits under Medicare
and Medicaid
• the number, characteristics, and use
of services and expenditures of
persons and families with various
forms of insurance
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• annual estimates of consumer
satisfaction with health care, and
indicators of health care quality for
key conditions
• annual estimates to track disparities
in health care use and access
In addition to national estimates, data
collected in this ongoing longitudinal
study are used to study the
determinants of the use of services and
expenditures, and changes in the access
to and the provision of health care in
relation to:
• Socio-economic and demographic
factors such as employment or income
• the health status and satisfaction with
health care of individuals and
families
• the health needs and circumstances of
specific subpopulation groups such as
the elderly and children
To meet the need for national data on
health care use, access, cost and quality,
MEPS–HC collects information on:
• Access to care and barriers to
receiving needed care
• satisfaction with usual providers
• health status and limitations in
activities
• medical conditions for which health
care was used
• use, expense and payment (as well as
insurance status of person receiving
care) for health services
Given the twin problems of
nonresponse and response error of some
household reported data, information is
collected directly from medical
providers in the MEPS–MPC to improve
the accuracy of expenditure estimates
derived from the MEPS–HC. Because of
their greater level of precision and
detail, we also use MEPS–MPC data as
the main source of imputations of
missing expenditure data. Thus, the
MEPS–MPC is designed to satisfy the
following analytical objectives:
• Serve as source data for household
reported events with missing
expenditure information
• Serve as an imputation source to
reduce the level of bias in survey
estimates of medical expenditures due
to item nonresponse and less
complete and less accurate household
data
• Serve as the primary data source for
expenditure estimates of medical care
provided by separately billing doctors
in hospitals, emergency rooms, and
outpatient departments, Medicaid
recipients and expenditure estimates
for pharmacies
• Allow for an examination of the level
of agreement in reported expenditures
from household respondents and
medical providers
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Data from the MEPS, both the HC and
MPC components, are intended for a
number of annual reports produced by
AHRQ, including the National
Healthcare Quality and Disparities
Report.
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 priority
condition enumeration, health status,
health care utilization including
prescribed medicines, expenses and
payments, employment, and health
insurance. Other topical areas that are
asked only once a year include access to
care, income, assets, satisfaction with
providers, and children’s health. While
many of the questions are asked about
the entire reporting unit (RU), 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
https://meps.ahrq.gov/mepsweb/survey_
comp/survey_questionnaires.jsp .
2. Adult Self-Administered
Questionnaire. A brief self-administered
questionnaire (SAQ) is used to collect
self-reported (rather than through
household proxy) health opinions and
satisfaction with health care, and
information on health status, preventive
care and health care quality measures
for adults 18 and older.
3. Diabetes Care SAQ. A brief selfadministered paper-and-pencil
questionnaire on the quality of diabetes
care is administered once a year (during
rounds 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
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asked if their diabetes is being treated
with diet, oral medications or insulin.
4. Authorization forms for the MEPS–
MPC Provider and Pharmacy Survey.
We ask respondents for authorization to
obtain supplemental information from
their medical providers (hospitals,
physicians, home health agencies and
institutions) and pharmacies.
5. MEPS Validation Interview. Each
interviewer is required to have at least
15 percent of his/her caseload validated
to insure that the computer assisted
personal interview (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 their 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.
Proposed HC Additions
6. Mental Health SAQ. MEPS will
include a new self-administered
questionnaire for spring of 2020 data
collection targeting the adult (age 18
and over) population. The questionnaire
includes questions addressing issues in
regards to an individual’s mental health
and mental health treatment including
mental health status, access to care,
barriers to care, experiences with care,
and use of peer support and other
services. AHRQ worked with several
experts in the mental health field to
develop this self-administered
questionnaire and used their expertise
to take advantage of already tested and
widely accepted measures in the SAQ.
7. Health Insurance Cost Sharing
Collection. AHRQ is seeking to enhance
data collection practices in the 2020
fielding of the MEPS–HC to collect more
detailed health insurance cost-sharing
information from respondents with
current private insurance, Medicare
Advantage, or Medicare Part D
Prescription Drug plans. Specifically,
we will ask respondents to provide a
document for themselves and family
members that includes information on
plan deductibles, out-of-pocket
maximums and other cost sharing
details for specific services. An example
of the type of document we propose to
collect is the Summary of Benefits and
Coverage (SBC). AHRQ worked with
experts on a feasibility study to identify
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the best methods for collecting these
types of documents in a way that would
minimize respondent burden (OMB
approval 0935–0124).
8. Pilot Test on Sampling NHIS
Nonrespondents. This test will be
conducted on a relatively small sample
of households in a few selected primary
sampling units (PSUs) in the 2020
spring data collection cycle. The sample
households for this test will be drawn
from nonrespondents to the 2019 NHIS
(which are not currently part of the
MEPS frame) and only the MEPS Round
1 interview will be administered. The
purpose of the test is to evaluate the
potential effectiveness of including a
sample of NHIS nonrespondents in
future MEPS panels to mitigate the
impact of declining NHIS response rates
on the overall MEPS response rate. The
general trend of declining response rates
for household surveys is problematic
and this evaluation is designed to
explore an avenue to stop further
declines and potentially improve the
overall MEPS response rate.
To achieve the goal of the MEPS–MPC
the following data collections are
implemented. No updates to the MEPS–
MPC are being requested:
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. A unique
screening instrument is used for each of
these seven provider types in the
MEPS–MPC, except for the two home
care provider types which use the same
screening form.
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. Some
HMOs may be included in this provider
type.
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.
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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.
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.
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
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;
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.
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’s
administrative office also has to be
contacted to determine whether the
doctors identified by medical records
billed separately from the institution
itself. Some HMOs may be included in
this provider type.
8. Pharmacy Data Collection
Questionnaire. This questionnaire
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requests the National Drug Code (NDC)
and when that is not available the
prescription name, strength and form as
well as the date prescription was filled,
payments by source, the 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.
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 13,338 * (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
Female SAQ (PSAQ) and Adult SAQ
(SAQ) will be completed once a year by
each female person in the RU that is 18
years old and older, an estimated 12,984
persons. The Adult Male SAQ (PSAQ)
and Adult SAQ (SAQ) will be
completed once a year by each male
person in the RU that is 18 years old
and older, an estimated 11,985 persons.
The Adult SAQs each require an average
of 7 minutes to complete. The Mental
Health SAQ will be completed during
Round 1, Panel 25; Round 3, Panel 24;
Round 5, Panel 23 interviews by each
person in the RU that is 18 years old
and older, an estimated 24,969 persons,
and takes about 7 minutes to complete.
The Diabetes care SAQ will be
completed once a year by each person
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in the RU identified as having diabetes,
an estimated 2,072 persons, and takes
about 3 minutes to complete. The
12,804 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. The
Health Insurance Cost Sharing
collection will be completed during
Round 1, Panel 25 and Round 3, Panel
24 by each RU with a current private
health insurance plan, a Medicare
Advantage plan, or a Medicare Part D
plan. An estimated 5,835 respondents
will locate and provide cost-sharing
documentation for an average of 1.3
plans per eligible RU. This activity will
require 45 minutes to complete for each
plan. 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 68,772 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 13 minutes to
complete. The total annual burden
hours for the MEPS–MPC are estimated
to be 17,388 hours. The total annual
burden for the MEPS–HC and MPC is
estimated to be 86,160 hours.
The total estimated annual burden
hours for the MEPS has increased from
77,666 hours in the previous clearance
to 86,160 hours in this clearance
request, an increase of 2,913 hours due
to the addition of the Mental Health
SAQ, 5,689 hours due to the health
insurance cost sharing collection, and
230 hours due to the pilot test on
sampling NHIS nonrespondents.
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 $1,673,909; the annual cost burden
for the MEPS–MPC is estimated to be
$298,580. The total annual cost burden
for the MEPS–HC and MPC is estimated
to be $1,972,489.
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EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents
Form name
Number of
responses per
respondent
Total
burden
hours
Hours per
response
MEPS–HC
* 13,338
2.5
92/60
51,129
12,984
1
7/60
1,515
11,985
2,072
24,969
12,804
12,804
5,835
4,225
150
102,366
1
1
1
5.4
3.1
1.3
1
1
na
7/60
3/60
7/60
3/60
3/60
45/60
5/60
92/60
na
1,398
104
2,913
3,457
1,985
5,689
352
230
68,772
MPC Contact Guide/Screening
.............................................................
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 ...............................................................................
Subtotal for the MEPS–MPC ...........................................................................
36,598
635
11
11,210
12,397
5,310
116
6,919
73,196
1
1.53
1
1.65
3.46
3.26
2.05
2.92
na
2/60
9/60
11/60
10/60
13/60
9/60
9/60
3/60
na
1,220
146
2
3,083
9,294
2,597
36
1,010
17,388
Grand Total ...............................................................................................
175, 562
na
na
86,160
MEPS–HC Core Interview ...............................................................................
Adult Female SAQ (PSAQ)—Years 2019 and 2021; Adult SAQ (SAQ)—
Year 2020 .....................................................................................................
Adult Male SAQ (PSAQ)—Years 2019 and 2021; Adult SAQ (SAQ)—Year
2020 .............................................................................................................
Diabetes care SAQ ..........................................................................................
Mental Health SAQ—Year 2020 .....................................................................
Authorization form for the MEPS–MPC Provider Survey ................................
Authorization form for the MEPS–MPC Pharmacy Survey .............................
Health Insurance Cost Sharing Collection—2020 ...........................................
MEPS–HC Validation Interview .......................................................................
Pilot Test on Sampling NHIS Nonrespondents—2020 ....................................
Subtotal for the MEPS–HC ..............................................................................
MEPS–MPC
Call **
* While the expected number of responding units for the annual estimates is 12,804, it is necessary to adjust for survey attrition of initial respondents by a factor of 0.96 (13,338=12,804/0.96).
** 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, which use the same contact guide.
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents
Form name
Total
burden hours
Average
hourly wage
rate
Total cost
burden
MEPS–HC
MEPS–HC Core Interview ...............................................................................
Adult Female SAQ (PSAQ)—Years 2019 and 2021; Adult SAQ (SAQ)—
Year 2020 .....................................................................................................
Adult Male SAQ (PSAQ)—Years 2019 and 2021; Adult SAQ (SAQ)—Year
2020 .............................................................................................................
Diabetes care SAQ ..........................................................................................
Mental Health SAQ—Year 2020 .....................................................................
Authorization forms for the MEPS–MPC Provider Survey ..............................
Authorization form for the MEPS–MPC Pharmacy Survey .............................
Health Insurance Cost Sharing Collection—2020 ...........................................
MEPS–HC Validation Interview .......................................................................
Pilot Test on Sampling NHIS Nonrespondents—2020 ....................................
Subtotal for the MEPS–HC ..............................................................................
13,338
51,129
$24.34
$1,244,480
12,984
1,515
* 24.34
36,875
11,985
2,072
24,969
12,804
12,804
5,835
4,225
150
102,366
1,398
104
2,913
3,457
1,985
5,689
352
230
68,800
* 24.34
34,027
2,531
70,902
84,143
48,315
138,470
8,568
5,598
1,673,909
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 ...............................................................................
Subtotal for the MEPS–MPC ...........................................................................
36,598
635
11
11,210
12,397
5,310
116
6,919
73,196
1,220
146
2
3,083
9,294
2,597
36
1,010
17,388
**17.25
Grand Total ...............................................................................................
175, 562
........................
*24.34
*24.34
*24.34
*24.34
*24.34
*24.34
*24.34
na
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MEPS–MPC
* Mean
hourly wage for All Occupations (00–0000).
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na
21,045
2,519
35
53,182
160,322
44,798
621
16,059
298,580
na
1,972,489
**17.25
**17.25
**17.25
**17.25
**17.25
**17.25
***15.90
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** Mean
*** Mean
hourly wage for Medical Secretaries (43–6013).
hourly wage for Pharmacy Technicians (29–2052).
Occupational Employment Statistics,
May 2017 National Occupational
Employment and Wage Estimates
United States, U.S. Department of Labor,
Bureau of Labor Statistics.
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’s health care
research and health care 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.
Gopal Khanna,
Director.
[FR Doc. 2019–08765 Filed 4–30–19; 8:45 am]
BILLING CODE 4160–90–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2013–N–0134]
Agency Information Collection
Activities; Proposed Collection;
Comment Request; Mammography
Quality Standards Act Requirements
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
The Food and Drug
Administration (FDA or Agency) is
announcing an opportunity for public
comment on the proposed collection of
certain information by the Agency.
Under the Paperwork Reduction Act of
1995 (PRA), Federal Agencies are
required to publish notice in the
Federal Register concerning each
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SUMMARY:
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proposed collection of information,
including each proposed extension of an
existing collection of information, and
to allow 60 days for public comment in
response to the notice. This notice
solicits comments on the estimated
reporting, recordkeeping, and thirdparty disclosure burden associated with
the Mammography Quality Standards
Act requirements.
DATES: Submit either electronic or
written comments on the collection of
information by July 1, 2019.
ADDRESSES: You may submit comments
as follows. Please note that late,
untimely filed comments will not be
considered. Electronic comments must
be submitted on or before July 1, 2019.
The https://www.regulations.gov
electronic filing system will accept
comments until 11:59 p.m. Eastern Time
at the end of July 1, 2019. Comments
received by mail/hand delivery/courier
(for written/paper submissions) will be
considered timely if they are
postmarked or the delivery service
acceptance receipt is on or before that
date.
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal:
https://www.regulations.gov. Follow the
instructions for submitting comments.
Comments submitted electronically,
including attachments, to https://
www.regulations.gov will be posted to
the docket unchanged. Because your
comment will be made public, you are
solely responsible for ensuring that your
comment does not include any
confidential information that you or a
third party may not wish to be posted,
such as medical information, your or
anyone else’s Social Security number, or
confidential business information, such
as a manufacturing process. Please note
that if you include your name, contact
information, or other information that
identifies you in the body of your
comments, that information will be
posted on https://www.regulations.gov.
• If you want to submit a comment
with confidential information that you
do not wish to be made available to the
public, submit the comment as a
written/paper submission and in the
manner detailed (see ‘‘Written/Paper
Submissions’’ and ‘‘Instructions’’).
Written/Paper Submissions
Submit written/paper submissions as
follows:
PO 00000
Frm 00075
Fmt 4703
Sfmt 4703
• Mail/Hand Delivery/Courier (for
written/paper submissions): Dockets
Management Staff (HFA–305), Food and
Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
• For written/paper comments
submitted to the Dockets Management
Staff, FDA will post your comment, as
well as any attachments, except for
information submitted, marked and
identified, as confidential, if submitted
as detailed in ‘‘Instructions.’’
Instructions: All submissions received
must include the Docket No. FDA–
2013–N–0134 for ‘‘Agency Information
Collection Activities; Proposed
Collection; Comment Request;
Mammography Quality Standards Act
Requirements.’’ Received comments,
those filed in a timely manner (see
ADDRESSES), will be placed in the docket
and, except for those submitted as
‘‘Confidential Submissions,’’ publicly
viewable at https://www.regulations.gov
or at the Dockets Management Staff
between 9 a.m. and 4 p.m., Monday
through Friday.
• Confidential Submissions—To
submit a comment with confidential
information that you do not wish to be
made publicly available, submit your
comments only as a written/paper
submission. You should submit two
copies total. One copy will include the
information you claim to be confidential
with a heading or cover note that states
‘‘THIS DOCUMENT CONTAINS
CONFIDENTIAL INFORMATION.’’ The
Agency will review this copy, including
the claimed confidential information, in
its consideration of comments. The
second copy, which will have the
claimed confidential information
redacted/blacked out, will be available
for public viewing and posted on
https://www.regulations.gov. Submit
both copies to the Dockets Management
Staff. If you do not wish your name and
contact information to be made publicly
available, you can provide this
information on the cover sheet and not
in the body of your comments and you
must identify this information as
‘‘confidential.’’ Any information marked
as ‘‘confidential’’ will not be disclosed
except in accordance with 21 CFR 10.20
and other applicable disclosure law. For
more information about FDA’s posting
of comments to public dockets, see 80
FR 56469, September 18, 2015, or access
the information at: https://www.gpo.gov/
fdsys/pkg/FR-2015-09-18/pdf/201523389.pdf.
Docket: For access to the docket to
read background documents or the
E:\FR\FM\01MYN1.SGM
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]]>Agencies
[Federal Register Volume 84, Number 84 (Wednesday, May 1, 2019)]
[Notices]
[Pages 18544-18548]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-08765]
[[Page 18544]]
-----------------------------------------------------------------------
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 updates to the
currently approved information collection project: ``Medical
Expenditure Panel Survey (MEPS) Household Component.''
DATES: Comments on this notice must be received by July 1, 2019.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at
[email protected].
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 emails at
[email protected].
SUPPLEMENTARY INFORMATION:
Proposed Project
In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-
3521, AHRQ invites the public to comment on this proposed information
collection. This request is for an update to the previously submitted
and OMB-approved clearance for the data collections of the Household
and Medical Provider Components of the Medical Expenditure Panel Survey
(MEPS). The previous OMB clearance request for the MEPS was approved
November, 2018, with an expiration date of November 30, 2021. We
propose updating the MEPS -HC by (1) adding a self-administered
questionnaire focusing on mental health, (2) collecting a health
insurance cost-sharing document and (3) implementing a pilot study to
evaluate the potential effectiveness of including a sample of NHIS
nonrespondents in future MEPS panels as a strategy to improve the
overall MEPS response rate.
Medical Expenditure Panel Survey (MEPS) Household Component and the
MEPS Medical Provider Component
Household Component: A sample of households participating
in the National Health Interview Survey (NHIS) in the prior calendar
year are interviewed 5 times over a 2 and one half (2.5) year period.
These 5 interviews yield two years of information on use of, and
expenditures for, health care, sources of payment for that health care,
insurance status, employment, health status and health care quality.
Medical Provider Component: The MEPS-MPC collects
information from medical and financial records maintained by hospitals,
physicians, pharmacies and home health agencies named as sources of
care by household respondents.
Insurance Component (MEPS-IC): The MEPS-IC collects
information on establishment characteristics, insurance offerings and
premiums from employers. The MEPS-IC is conducted by the Census Bureau
for AHRQ and is cleared separately.
The MEPS is a multi-purpose survey. In addition to collecting data
to yield annual estimates for a variety of measures related to health
care use and expenditures, MEPS also provides estimates of measures
related to health status, consumer assessment of health care, health
insurance coverage, demographic characteristics, employment and access
to health care indicators. Estimates can be provided for individuals,
families and population subgroups of interest. Data obtained in this
study are used to provide, among others, the following national
estimates:
Annual estimates of health care use and expenditures for
persons and families
annual estimates of sources of payment for health care
utilizations, including public programs such as Medicare and Medicaid,
private insurance, and out of pocket payments
annual estimates of health care use, expenditures and sources
of payment of persons and families by type of utilization including
inpatient stay, ambulatory care, home health, dental care and
prescribed medications
the number and characteristics of the population eligible for
public programs including the use of services and expenditures of the
population(s) eligible for benefits under Medicare and Medicaid
the number, characteristics, and use of services and
expenditures of persons and families with various forms of insurance
annual estimates of consumer satisfaction with health care,
and indicators of health care quality for key conditions
annual estimates to track disparities in health care use and
access
In addition to national estimates, data collected in this ongoing
longitudinal study are used to study the determinants of the use of
services and expenditures, and changes in the access to and the
provision of health care in relation to:
Socio-economic and demographic factors such as employment or
income
the health status and satisfaction with health care of
individuals and families
the health needs and circumstances of specific subpopulation
groups such as the elderly and children
To meet the need for national data on health care use, access, cost
and quality, MEPS-HC collects information on:
Access to care and barriers to receiving needed care
satisfaction with usual providers
health status and limitations in activities
medical conditions for which health care was used
use, expense and payment (as well as insurance status of
person receiving care) for health services
Given the twin problems of nonresponse and response error of some
household reported data, information is collected directly from medical
providers in the MEPS-MPC to improve the accuracy of expenditure
estimates derived from the MEPS-HC. Because of their greater level of
precision and detail, we also use MEPS-MPC data as the main source of
imputations of missing expenditure data. Thus, the MEPS-MPC is designed
to satisfy the following analytical objectives:
Serve as source data for household reported events with
missing expenditure information
Serve as an imputation source to reduce the level of bias in
survey estimates of medical expenditures due to item nonresponse and
less complete and less accurate household data
Serve as the primary data source for expenditure estimates of
medical care provided by separately billing doctors in hospitals,
emergency rooms, and outpatient departments, Medicaid recipients and
expenditure estimates for pharmacies
Allow for an examination of the level of agreement in reported
expenditures from household respondents and medical providers
[[Page 18545]]
Data from the MEPS, both the HC and MPC components, are intended
for a number of annual reports produced by AHRQ, including the National
Healthcare Quality and Disparities Report.
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 priority condition enumeration,
health status, health care utilization including prescribed medicines,
expenses and payments, employment, and health insurance. Other topical
areas that are asked only once a year include access to care, income,
assets, satisfaction with providers, and children's health. While many
of the questions are asked about the entire reporting unit (RU), 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 https://meps.ahrq.gov/mepsweb/survey_comp/survey_questionnaires.jsp .
2. Adult Self-Administered Questionnaire. A brief self-administered
questionnaire (SAQ) is used to collect self-reported (rather than
through household proxy) health opinions and satisfaction with health
care, and information on health status, preventive care and health care
quality measures for adults 18 and older.
3. Diabetes Care SAQ. A brief self-administered paper-and-pencil
questionnaire on the quality of diabetes care is administered once a
year (during rounds 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.
4. Authorization forms for the MEPS-MPC Provider and Pharmacy
Survey. We ask respondents for authorization to obtain supplemental
information from their medical providers (hospitals, physicians, home
health agencies and institutions) and pharmacies.
5. MEPS Validation Interview. Each interviewer is required to have
at least 15 percent of his/her caseload validated to insure that the
computer assisted personal interview (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 their 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.
Proposed HC Additions
6. Mental Health SAQ. MEPS will include a new self-administered
questionnaire for spring of 2020 data collection targeting the adult
(age 18 and over) population. The questionnaire includes questions
addressing issues in regards to an individual's mental health and
mental health treatment including mental health status, access to care,
barriers to care, experiences with care, and use of peer support and
other services. AHRQ worked with several experts in the mental health
field to develop this self-administered questionnaire and used their
expertise to take advantage of already tested and widely accepted
measures in the SAQ.
7. Health Insurance Cost Sharing Collection. AHRQ is seeking to
enhance data collection practices in the 2020 fielding of the MEPS-HC
to collect more detailed health insurance cost-sharing information from
respondents with current private insurance, Medicare Advantage, or
Medicare Part D Prescription Drug plans. Specifically, we will ask
respondents to provide a document for themselves and family members
that includes information on plan deductibles, out-of-pocket maximums
and other cost sharing details for specific services. An example of the
type of document we propose to collect is the Summary of Benefits and
Coverage (SBC). AHRQ worked with experts on a feasibility study to
identify the best methods for collecting these types of documents in a
way that would minimize respondent burden (OMB approval 0935-0124).
8. Pilot Test on Sampling NHIS Nonrespondents. This test will be
conducted on a relatively small sample of households in a few selected
primary sampling units (PSUs) in the 2020 spring data collection cycle.
The sample households for this test will be drawn from nonrespondents
to the 2019 NHIS (which are not currently part of the MEPS frame) and
only the MEPS Round 1 interview will be administered. The purpose of
the test is to evaluate the potential effectiveness of including a
sample of NHIS nonrespondents in future MEPS panels to mitigate the
impact of declining NHIS response rates on the overall MEPS response
rate. The general trend of declining response rates for household
surveys is problematic and this evaluation is designed to explore an
avenue to stop further declines and potentially improve the overall
MEPS response rate.
To achieve the goal of the MEPS-MPC the following data collections
are implemented. No updates to the MEPS-MPC are being requested:
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. A unique screening instrument is used for
each of these seven provider types in the MEPS-MPC, except for the two
home care provider types which use the same screening form.
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. Some HMOs may be included in this provider type.
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.
[[Page 18546]]
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.
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.
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 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; 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.
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's administrative office also has to be contacted to
determine whether the doctors identified by medical records billed
separately from the institution itself. Some HMOs may be included in
this provider type.
8. Pharmacy Data Collection Questionnaire. This questionnaire
requests the National Drug Code (NDC) and when that is not available
the prescription name, strength and form as well as the date
prescription was filled, payments by source, the 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.
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 13,338 * (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 Female SAQ (PSAQ) and Adult SAQ (SAQ) will be completed once a
year by each female person in the RU that is 18 years old and older, an
estimated 12,984 persons. The Adult Male SAQ (PSAQ) and Adult SAQ (SAQ)
will be completed once a year by each male person in the RU that is 18
years old and older, an estimated 11,985 persons. The Adult SAQs each
require an average of 7 minutes to complete. The Mental Health SAQ will
be completed during Round 1, Panel 25; Round 3, Panel 24; Round 5,
Panel 23 interviews by each person in the RU that is 18 years old and
older, an estimated 24,969 persons, and takes about 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 2,072
persons, and takes about 3 minutes to complete. The 12,804 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. The
Health Insurance Cost Sharing collection will be completed during Round
1, Panel 25 and Round 3, Panel 24 by each RU with a current private
health insurance plan, a Medicare Advantage plan, or a Medicare Part D
plan. An estimated 5,835 respondents will locate and provide cost-
sharing documentation for an average of 1.3 plans per eligible RU. This
activity will require 45 minutes to complete for each plan. 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 68,772 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 13 minutes to
complete. The total annual burden hours for the MEPS-MPC are estimated
to be 17,388 hours. The total annual burden for the MEPS-HC and MPC is
estimated to be 86,160 hours.
The total estimated annual burden hours for the MEPS has increased
from 77,666 hours in the previous clearance to 86,160 hours in this
clearance request, an increase of 2,913 hours due to the addition of
the Mental Health SAQ, 5,689 hours due to the health insurance cost
sharing collection, and 230 hours due to the pilot test on sampling
NHIS nonrespondents.
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 $1,673,909;
the annual cost burden for the MEPS-MPC is estimated to be $298,580.
The total annual cost burden for the MEPS-HC and MPC is estimated to be
$1,972,489.
[[Page 18547]]
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.......................... \*\ 13,338 2.5 92/60 51,129
Adult Female SAQ (PSAQ)--Years 2019 and 2021; 12,984 1 7/60 1,515
Adult SAQ (SAQ)--Year 2020.....................
Adult Male SAQ (PSAQ)--Years 2019 and 2021; 11,985 1 7/60 1,398
Adult SAQ (SAQ)--Year 2020.....................
Diabetes care SAQ............................... 2,072 1 3/60 104
Mental Health SAQ--Year 2020.................... 24,969 1 7/60 2,913
Authorization form for the MEPS-MPC Provider 12,804 5.4 3/60 3,457
Survey.........................................
Authorization form for the MEPS-MPC Pharmacy 12,804 3.1 3/60 1,985
Survey.........................................
Health Insurance Cost Sharing Collection--2020.. 5,835 1.3 45/60 5,689
MEPS-HC Validation Interview.................... 4,225 1 5/60 352
Pilot Test on Sampling NHIS Nonrespondents--2020 150 1 92/60 230
Subtotal for the MEPS-HC........................ 102,366 na na 68,772
----------------------------------------------------------------------------------------------------------------
MEPS-MPC
----------------------------------------------------------------------------------------------------------------
MPC Contact Guide/Screening Call \**\........... 36,598 1 2/60 1,220
Home care for health care providers 635 1.53 9/60 146
questionnaire..................................
Home care for non-health care providers 11 1 11/60 2
questionnaire..................................
Office-based providers questionnaire............ 11,210 1.65 10/60 3,083
Separately billing doctors questionnaire........ 12,397 3.46 13/60 9,294
Hospitals questionnaire......................... 5,310 3.26 9/60 2,597
Institutions (non-hospital) questionnaire....... 116 2.05 9/60 36
Pharmacies questionnaire........................ 6,919 2.92 3/60 1,010
Subtotal for the MEPS-MPC....................... 73,196 na na 17,388
---------------------------------------------------------------
Grand Total................................. 175, 562 na na 86,160
----------------------------------------------------------------------------------------------------------------
* While the expected number of responding units for the annual estimates is 12,804, it is necessary to adjust
for survey attrition of initial respondents by a factor of 0.96 (13,338=12,804/0.96).
** 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, which use the same contact guide.
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Number of Total burden Average hourly Total cost
Form name respondents hours wage rate burden
----------------------------------------------------------------------------------------------------------------
MEPS-HC
----------------------------------------------------------------------------------------------------------------
MEPS-HC Core Interview.......................... 13,338 51,129 $24.34 $1,244,480
Adult Female SAQ (PSAQ)--Years 2019 and 2021; 12,984 1,515 \*\ 24.34 36,875
Adult SAQ (SAQ)--Year 2020.....................
Adult Male SAQ (PSAQ)--Years 2019 and 2021; 11,985 1,398 \*\ 24.34 34,027
Adult SAQ (SAQ)--Year 2020.....................
Diabetes care SAQ............................... 2,072 104 \*\24.34 2,531
Mental Health SAQ--Year 2020.................... 24,969 2,913 \*\24.34 70,902
Authorization forms for the MEPS-MPC Provider 12,804 3,457 \*\24.34 84,143
Survey.........................................
Authorization form for the MEPS-MPC Pharmacy 12,804 1,985 \*\24.34 48,315
Survey.........................................
Health Insurance Cost Sharing Collection--2020.. 5,835 5,689 \*\24.34 138,470
MEPS-HC Validation Interview.................... 4,225 352 \*\24.34 8,568
Pilot Test on Sampling NHIS Nonrespondents--2020 150 230 \*\24.34 5,598
Subtotal for the MEPS-HC........................ 102,366 68,800 na 1,673,909
----------------------------------------------------------------------------------------------------------------
MEPS-MPC
----------------------------------------------------------------------------------------------------------------
MPC Contact Guide/Screening Call................ 36,598 1,220 \**\17.25 21,045
Home care for health care providers 635 146 \**\17.25 2,519
questionnaire..................................
Home care for non[dash]health care providers 11 2 \**\17.25 35
questionnaire..................................
Office[dash]based providers questionnaire....... 11,210 3,083 \**\17.25 53,182
Separately billing doctors questionnaire........ 12,397 9,294 \**\17.25 160,322
Hospitals questionnaire......................... 5,310 2,597 \**\17.25 44,798
Institutions (non-hospital) questionnaire....... 116 36 \**\17.25 621
Pharmacies questionnaire........................ 6,919 1,010 \***\15.90 16,059
Subtotal for the MEPS-MPC....................... 73,196 17,388 na 298,580
---------------------------------------------------------------
Grand Total................................. 175, 562 .............. na 1,972,489
----------------------------------------------------------------------------------------------------------------
\*\ Mean hourly wage for All Occupations (00-0000).
[[Page 18548]]
\**\ Mean hourly wage for Medical Secretaries (43-6013).
\***\ Mean hourly wage for Pharmacy Technicians (29-2052).
Occupational Employment Statistics, May 2017 National Occupational
Employment and Wage Estimates United States, U.S. Department of Labor,
Bureau of Labor Statistics.
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's health care research and
health care 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.
Gopal Khanna,
Director.
[FR Doc. 2019-08765 Filed 4-30-19; 8:45 am]
BILLING CODE 4160-90-P
