OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Healthcare Effectiveness Data and Information Set (HEDIS) Data Collection for Medicare Advantage

ICR 201309-0938-001 · OMB 0938-1028 · Historical Active

Forms and Documents
Document
Name
Status
Supporting Statement B
2013-08-27
Supplementary Document
2013-08-27
Supplementary Document
2013-08-27
Supplementary Document
2013-08-27
Supporting Statement A
2013-08-27
IC Document Collections
IC ID
Document
Title
Status
181326 Modified
ICR Details
0938-1028 201309-0938-001
Historical Active 201009-0938-020
HHS/CMS 20416
Healthcare Effectiveness Data and Information Set (HEDIS) Data Collection for Medicare Advantage
Revision of a currently approved collection   No
Regular
Approved without change 02/14/2014
Retrieve Notice of Action (NOA) 09/10/2013
  Inventory as of this Action Requested Previously Approved
02/28/2017 36 Months From Approved 02/28/2014
573 0 483
184,320 0 154,560
0 0 7,245,000
CMS has a responsibility to its Medicare beneficiaries to ensure that care provided by Medicare Advantage (MA) contracts to CMS is of high quality and conforms to currently acceptable standards of medical care. CMS accomplishes this through the collection, analysis and dissemination of HEDIS data, the most widely used standardized clinical performance measurement set in managed care. Since January 1997, Medicare managed care contracts have been required to annually report quality of care performance measures from HEDIS. In April 1997, CMS began working with NCQA to implement HEDIS data collection directly into the Medicare managed care program. It is critical to the agency's mission that CMS continues to collect and disseminate information that will help beneficiaries choose among health plans; information that contributes to better health care through the identification of quality improvement opportunities; and provides for proper oversight and management of the Medicare program. These data are used in external CMS information products issued to beneficiaries, and are published on the CMS public website. These data are also made publicly available through public use files (PUFs) posted on the CMS website. CMS relies heavily on HEDIS data for contractor surveillance and assessment activities. It is critical to the agency's mission that CMS continues to collect and disseminate information that will help beneficiaries choose among health plans; information that contributes to better health care through the identification of quality improvement opportunities; and provides for proper oversight and management of the Medicare program.
US Code: 42 USC Sec. 1395w-22(e)(3)(A) Name of Law: Benefits and beneficiary protections
   PL: Pub.L. 108 - 173 722 (a)(3)(A)(i) Name of Law: MMA
   Statute at Large: 18 Stat. 1852 Name of Statute: null
  
None
Not associated with rulemaking
  78 FR 34387 06/07/2013
78 FR 50057 08/16/2013
No
1
IC Title Form No. Form Name
HEDIS Information Collection Request (CMS-10219)
  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 573 483 0 0 90 0
Annual Time Burden (Hours) 184,320 154,560 0 0 29,760 0
Annual Cost Burden (Dollars) 0 7,245,000 0 0 -7,245,000 0
No
No
The increased hours and wages are due to the increased number of contracts from 483 plans to 576 contracts. Also, there is increased quality assurance in the HEDIS? data submission and corresponding increase in the labor categories for the contracts for the medical review technologist and a database administrator. The increased quality assurance is because HEDIS? measures are used for the CMS Star Ratings that are publicly reported and for determining the ratings for the Quality Bonus Payments.
$325,000
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov
  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.
09/10/2013