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Federal forms, ICRs, and supporting documents

Information Collection Request

HEDIS Data Collection for Medicare Advantage (CMS-10219)

ICR 202006-0938-017 · OMB 0938-1028 · Received in OIRA

Forms and Documents
Document
Name
Status
Supporting Statement A
2020-07-01
Supplementary Document
2020-06-25
Supporting Statement B
2020-06-25
IC Document Collections
IC ID
Document
Title
Status
181326 Modified
ICR Details
0938-1028 202006-0938-017
Received in OIRA 201702-0938-017
HHS/CMS CM-CPC
HEDIS Data Collection for Medicare Advantage (CMS-10219)
Revision of a currently approved collection   No
Regular 07/01/2020
  Requested Previously Approved
36 Months From Approved 01/31/2021
677 515
216,640 164,800
0 0
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
   Statute at Large: 18 Stat. 1852 Name of Statute: null
   PL: Pub.L. 108 - 173 722 (a)(3)(A)(i) Name of Law: MMA
  
None
Not associated with rulemaking
  85 FR 21010 04/15/2020
85 FR 39570 07/01/2020
No
1
IC Title Form No. Form Name
HEDIS Information Collection Request
  Total Request 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 677 515 0 0 162 0
Annual Time Burden (Hours) 216,640 164,800 0 0 51,840 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
There have been very minor changes in the measurement set for HEDIS. Six measures are removed or retired and two measures are added. The two new measures relate to opioid prescribing, while the Body Mass Index measure and the Rheumatoid Arthritis measure are both removed due to being topped out. Four measures regarding descriptive information about the health plan have been removed since these data can be obtained through other sources. The hours and the costs are greater in this package because in 2017 there were 515 MAOs and in 2020 there are 677 MAOs.
$526,138
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Stephan McKenzie 410 786-1943 stephan.mckenzie@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.
07/01/2020