Marketplace Quality Standards (CMS-10520)

Forms and Documents

Document Name	Status
Form CMS-10520 Monitoring and appeals process for survey vendors Form and Instruction	Modified
CMS-10520 - Supporting Statement 2019.docx Supporting Statement A	2019-06-26

IC Document Collections

IC ID	Document Title	Status
212995	Patient safety reporting standards for QHP issuers	Modified
212994	Reporting for the Enrollee Satisfaction Survey (ESS)	Modified
212992	Implementation and reporting for the Quality Rating System (QRS)	Modified
212011	Monitoring and appeals process for survey vendors Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1249	ICR Reference No: 201906-0938-006
Status: Historical Active	Previous ICR Reference No: 201603-0938-008
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Marketplace Quality Standards (CMS-10520)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/01/2019
	Date Received in OIRA: 06/27/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2022	36 Months From Approved	08/31/2019
Responses	764	0	1,770
Time Burden (Hours)	348,764	0	1,085,095
Cost Burden (Dollars)	0	0	0

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Abstract: Section 1311(c)(3) of the Affordable Care Act directs the Secretary to develop a system to rate QHPs on the basis of quality and price and requires Exchanges to display this quality rating information on their respective websites. Section 1311(c)(4) of the Affordable Care Act requires the Secretary to develop an enrollee satisfaction survey (ESS) system to assess enrollee experience with each QHP (with more than 500 enrollees in the previous year) offered through an Exchange. Section 1311(h) requires QHPs to contract with certain hospitals that meet specific patient safety and health care quality standards beginning January 1, 2015. CMS is requesting approval for information collection associated with these related Marketplace quality standards.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1311(c)(3)-(4) Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1311(h) Name of Law: Affordable Care Act
   US Code: 45 USC 156.1110 Name of Law: HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCH
  

Citations for New Statutory Requirements: US Code: 45 USC 156.1110 Name of Law: Establishment of patient safety standards for QHP issuers.

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 4075	02/14/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 30122	06/26/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Reporting for the Enrollee Satisfaction Survey (ESS)
Monitoring and appeals process for survey vendors	CMS-10520	Vendor Appeal Form
Implementation and reporting for the Quality Rating System (QRS)
Patient safety reporting standards for QHP issuers

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ICR Summary of Burden

	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	764	1,770	0	-356	-650	0
Annual Time Burden (Hours)	348,764	1,085,095	0	-1,281	-735,050	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is a decrease to the burden hour estimates approved in OMB control number 0938-1249. The total annual burden hour estimate (for the total estimated 264 respondents) associated with this revised information collection is 348,764 hours; and the total annual cost estimate associated is $44,247,221. The modifications to the QRS, QHP Enrollee Survey patient safety reporting associated information collection, based on the past three years of implementation of the programs, would result in an annual estimate decrease in burden hours of 736,306 hours (QRS implementation and reporting decreased by 716,500 hours [1,052,250 - 335,750 hours]; QHP Enrollee Survey implementation and reporting decreased by 18,550 hours [31,050 - 12,500 hours]; monitoring and appeals process for survey vendors decreased by 31 hours [45 -14 hours]); patients safety reporting for issuers decreased by 1225 hours [1725-500 hours] and decrease in cost burden of $30,775,569 for QHP issuers (QRS implementation and reporting decreased by $31,106,175 [$74,088,175 - $42,982,000]; QHP Enrollee Survey implementation and reporting increased by $439,230 [$776,020 - $1,215,250]; monitoring and appeals for survey vendors increased by $276 [$1085 - $1361]); and patient safety reporting cost burden decreased by $108,900 [$157,510 - $48,610].

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Annual Cost to Federal Government: $782,113

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 06/27/2019

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