OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Medicare Contractor Provider Satisfaction Survey (MCPSS) and Supporting Regulations in 42 CFR 421.120 and 421.122

ICR 200610-0938-006 · OMB 0938-0915 · Historical Active

Forms and Documents
Document
Name
Status
Form
 Modified
Supporting Statement B
2006-08-16
Justification for No Material/Nonsubstantive Change
2006-09-25
Supplementary Document
2006-08-16
Supporting Statement A
2006-08-16
IC Document Collections
IC ID
Document
Title
Status
8757 Modified
ICR Details
0938-0915 200610-0938-006
Historical Active 200604-0938-008
HHS/CMS
Medicare Contractor Provider Satisfaction Survey (MCPSS) and Supporting Regulations in 42 CFR 421.120 and 421.122
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 01/08/2007
Retrieve Notice of Action (NOA) 10/13/2006
  Inventory as of this Action Requested Previously Approved
06/30/2009 06/30/2009 06/30/2009
20,514 0 20,514
6,975 0 6,923
0 0 0
CMS will obtain feedback from over 30,000 Medicare Providers via a survey about satisfaction, attitudes and perceptions regarding the services provided by Medicare Fee-for-Service (FFS) Carriers, Fiscal Intermediaries, Durable Medical Equipment Suppliers, and Regional Home Health Intermediaries and Medicare Adminisrative Contractors. The survey focuses on basic business functions provided by the Medicare Contractors such as Inquiries, Provider Communications, Claims Processing, Appeals, Provider Enrollment, Medical Review and Provider Reimbursement.
None
None
Not associated with rulemaking
No
1
IC Title Form No. Form Name
Medicare Contractor Provider Satisfaction Survey (MCPSS) and Supporting Regulations in 42 CFR 421.120 and 421.122 CMS-10097 MCPSS Survey
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 20,514 20,514 0 0 0 0
Annual Time Burden (Hours) 6,975 6,923 0 52 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a change worksheet. The burden is not changing. We are submitting a revised survey instrument and a Non-Response Bias Report for the 2006 response rate to the survey. The survey was revised and several questions were removed. However, the burden remained the same. CMS agreed to submit the Non-Response Bias Report to OMB if the response rate was below 80%. Due to the rounding affects of the ROCIS burden calculator their appears to be an increase in the burden hours since the last clearance.
$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Saleda Perryman
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/25/2006