16134 Federal Register / Vol. 75, No. 61 / Wednesday, March 31, 2010 / Notices 

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. 

Dated: March 19, 2010. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2010–6778 Filed 3–30–10; 8:45 am] 

BILLING CODE 4160–90–M 

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 

information collection project: 

‘‘Collection of Information for Agency 

for Healthcare Research and Quality’s 

(AHRQ) Consumer Assessment of 

Healthcare Providers and Systems 

(CAHPS®) Health Plan Survey 

Comparative Database.’’ In accordance 

with the Paperwork Reduction Act, 44 

U.S.C. 3501–3520, AHRQ invites the 

public to comment on this proposed 

information collection. 

This proposed information collection 

was previously published in the Federal 

Register on January 25th, 2010 and 

allowed 60 days for public comment. No 

comments were received. The purpose 

of this notice is to allow an additional 

30 days for public comment. 

DATES: Comments on this notice must be 

received by April 30, 2010. 

ADDRESSES: Written comments should 

be submitted to: AHRQ’s OMB Desk 

Officer by fax at (202) 395–6974 

(attention: AHRQ’s desk officer) or by email at OIRA_submission@omb.eop.gov 

(attention: AHRQ’s desk officer). 

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 

e-mail at 

doris.letkowitz@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Collection of Information for Agency 

for Healthcare Research and Quality’s 

(AHRQ) Consumer Assessment of 

Healthcare Providers and Systems 

(CAHPS) Health Plan Survey 

Comparative Database 

The Agency for Healthcare Research 

and Quality (AHRQ) requests that the 

Office of Management and Budget 

(OMB) approve, under the Paperwork 

Reduction Act of 1995, AHRQ’s 

collection of information for the AHRQ 

Consumer Assessment of Healthcare 

Providers and Systems (CAHPS) 

Database for Health Plans. The CAHPS 

Health Plan Database consists of data 

from the AHRQ CAHPS Health Plan 

Survey. 

Health plans in the U.S. are asked to 

voluntarily submit data from the survey 

to AHRQ, through its contractor, Westat. 

The CAHPS Database was developed by 

AHRQ in 1998 in response to requests 

from health plans, purchasers, and the 

Centers for Medicare & Medicaid 

Services (CMS) to provide comparative 

data to support public reporting of 

health plan ratings, health plan 

accreditation and quality improvement. 

The CAHPS Health Plan Survey is a 

tool for collecting standardized 

information on enrollees’ experiences 

with health plans and their services. 

The development of the CAHPS Health 

Plan Survey began in 1995, when AHRQ 

awarded the first set of CAHPS grants to 

Harvard, RTI, and RAND. In 1997 the 

CAHPS 1.0 survey was released by the 

CAHPS Consortium. The CAHPS 

Consortium refers to the research 

organizations involved in the 

development, dissemination, and 

support of CAHPS products. The 

current Consortium includes AHRQ, 

CMS, RAND, Yale School of Public 

Health, and Westat. 

Since that time, the Consortium has 

clarified and updated the survey 

instrument to reflect field test results; 

feedback from industry experts; reports 

from health plan participants, data 

collection vendors, and other users; and 

evidence from cognitive testing and 

focus groups. In November 2006, the 

CAHPS Consortium released the latest 

version of the instrument: The CAHPS 

Health Plan Survey 4.0. The 

development of this update to the 

Health Plan Survey has been part of the 

‘‘Ambulatory CAHPS (A–CAHPS) 

Initiative,’’ which arose as a result of 

extensive research conducted with 

users. AHRQ released the CAHPS 

Health Plan Survey 4.0, along with 

guidance on how to customize and 

administer it. The National Quality 

Forum endorsed the 4.0 version of the 

Health Plan Survey in July 2007. 

The CAHPS Health Plan Database 

uses data from AHRQ’s standardized 

CAHPS Health plan survey to provide 

comparative results to health care 

purchasers, consumers, regulators and 

policy makers across the country. The 

Database also provides data for AHRQ’s 

annual National Healthcare Quality and 

National Healthcare Disparities Reports. 

Voluntary participants include public 

and private employers, State Medicaid 

agencies, State Children’s Health 

Insurance Programs (SCHIP), CMS, and 

individual health plans. 

The collection of information for the 

CAHPS Database for Health Plans is 

being conducted pursuant to AHRQ’s 

statutory authority to conduct and 

support research on health care and 

systems for the delivery of such care, 

including activities with respect to the 

quality, effectiveness, efficiency, 

appropriateness and value of health care 

services. See 42 U.S.C. 299a(a)(1). 

Method of Collection 

Information for the CAHPS Health 

Plan Database has been collected by 

AHRQ through its contractor Westat on 

an annual basis since 1998. Health plans 

are asked to voluntarily submit their 

data to the comparative database in June 

of each year. The data are cleaned with 

standardized programs, then aggregated 

and used to produce comparative results 

for commercial (adult and child), 

Medicaid (adult and child), and 

Medicare (adult) populations for the two 

most recent years. In addition, 

individual participant reports are 

produced that display the participating 

organizations’ own results compared to 

appropriate comparisons derived from 

the National, regional and product-type 

distributions on a password-protected 

section of the online reporting system. 

The CAHPS Health Plan Database 

receives the data from three sources. 

First, commercial health plan data is 

purchased by the CAHPS Health Plan 

Database directly from the National 

Committee for Quality Assurance 

(NCQA). The data is collected by NCQA 

from those who participate in its 

accreditation program. Second, 

Medicare data is provided by CMS 

through an agency data use agreement. 

The Medicare data is collected by CMS 


jlentini on DSKJ8SOYB1PROD with NOTICES
Federal Register / Vol. 75, No. 61 / Wednesday, March 31, 2010 / Notices 16135 

and their contractor from beneficiaries 

who were enrolled in a managed care 

health plan. Third, Medicaid data is 

collected by the CAHPS Health Plan 

Database. Medicaid agencies and their 

vendors directly submit their Medicaid 

health plan survey data to the CAHPS 

Health Plan Database through an online 

data submission system. Data submitted 

by Medicaid plans are compiled along 

with the data received from CMS and 

NCQA to comprise the CAHPS Health 

Plan Survey comparative database. 

Estimated Annual Respondent Burden 

Each year State Medicaid agencies 

and individual health plans decide 

whether to participate in the database 

and prepare their materials and dataset 

for submission to the CAHPS Health 

Plan Database. Participating 

organizations are typically State 

Medicaid agencies with multiple health 

plans. However, individual health plans 

are also encouraged to submit their data 

to the CAHPS Database. The number of 

data submissions per registrant varies 

from participant to participant and year 

to year because some participants 

submit data for multiple health plans, 

while others may only submit survey 

data for one plan. 

Each organization that decides to 

participate in the database must have 

their POC complete a registration form 

providing their contact information for 

access to the on-line data submission 

system, sign and submit a data use 

agreement (DUA), and provide health 

plan characteristics such as health plan 

name, product type, type of population 

surveyed, health plan state, and plan 

name to appear in the reporting of their 

results. 

Each vendor that submits files on 

behalf of a Medicaid agency or 

individual health plan must also 

complete the registration form in order 

to obtain access to the on-line 

submission system. The vendor, on 

behalf of their client, may also complete 

additional information about survey 

administration (CAHPS survey version 

used, mode of survey administration, 

total enrollment count, description of 

how the sample was selected), submit a 

copy of the questionnaire used, and 

submit one data file per health plan. 

Commercial health plan data is received 

directly from NCQA. Medicare health 

plan data is received from CMS. 

The burden hours and costs below 

pertain only to the collection of 

Medicaid data from State Medicaid 

agencies and individual Medicaid 

health plans because those are the only 

entities that submit data through the 

data submission process (other data are 

obtained directly from NCQA and CMS 

as noted earlier in Section 2). In 2009, 

a total of 60 participants, representing 

45 individual organizations and 15 

vendors, submitted data for 244 health 

plans (an average of about 4 health 

plans per participant). 

Exhibits 1 and 2 are based on the 

estimated number of individual 

participants (participating organizations 

and/or vendors) who will complete the 

database submission steps and forms in 

the coming years, and is not based on 

the total number of health plans that are 

submitted. The number of respondents 

and burden hours are based on an 

estimated slight increase in the number 

of participants to 70 in 2010 and 2011. 

In Exhibit 1, the 70 participants that 

will complete the registration form and 

submit information to the CAHPS 

Health Plan Database are a combination 

of an estimated 50 State Medicaid 

agencies and individual health plans, 

and 20 estimated vendors. The 50 State 

Medicaid agencies or individual health 

plans will sign and submit a DUA. 

Vendors do not sign or submit DUAs. 

Health plan information and data files 

are submitted for each health plan. 

Exhibit 1 shows an estimated total of 

280 health plans (70 estimated 

participants with 4 health plans per 

participant). The total burden hours for 

completing the registration, DUA and 

data submission process are estimated 

to be 722 hours. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Form name 

Number of 

respondents/ 

POCs 

Number of 

responses 

per POC 

Hours per 

response 

Total burden 

hours 

Registration Form and Data Submission * ....................................................... 70 1 7.6 532 

Data Use Agreement ** .................................................................................... 50 1 1 50 

Health Plan Information *** .............................................................................. 70 4 30/60 140 

Total .......................................................................................................... 190 NA NA 722 

* The online Registration Form requires about 5 minutes to complete; however over 7 hours is required to plan/prepare for the data submission. This includes the amount of time the participating organization, and others (CEO, lawyer, vendor) typically spend deciding whether to participate in the database and preparing their materials and dataset for submission to the CAHPS Health Plan Database and performing the submission. 

** The Data Use Agreement requires about 3 minutes to complete; however about 57 minutes is required for the participating organization to 

review the agreement prior to signing. This includes the review by the organization’s CEO or legal department. 

*** A few health plans may submit their data directly, however most health plan data will be submitted by the POC. 

Exhibit 2 shows the estimated 

annualized cost burden based on the 

respondents’ time to complete the 

submission process. The cost burden is 

estimated to be $31,046 annually. 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Form name Number of 

respondents 

Total burden 

hours 

Average hourly wage rate ** Total cost 

burden 

Registration Form and Data Submission * ....................................................... 70 532 $43.00 $22,876 

Data Use Agreement ....................................................................................... 50 50 43.00 2,150 

Health Plan Information ................................................................................... 70 140 43.00 6,020 


jlentini on DSKJ8SOYB1PROD with NOTICES
16136 Federal Register / Vol. 75, No. 61 / Wednesday, March 31, 2010 / Notices 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN—Continued 

Form name Number of 

respondents 

Total burden 

hours 

Average hourly wage rate ** Total cost 

burden 

Total .......................................................................................................... 190 722 NA 31,046 

*Wage rates were calculated using the mean hourly wage based on occupational employment and wage estimates from the Dept of Labor, 

Bureau of Labor Statistics’ May 2008 National Industry-Specific Occupational Employment and Wage Estimates NAICS 622000—located at 

http://www.bls.gov/oes/current/oes_nat.htm. **Wage rate of $43.00 is based on the mean hourly wages for Medical and Health Services Managers. Wage rate of $42.67 is the weighted 

mean hourly wage for: Medical and Health Services Managers ($42.67 × 2.6 hours = $110.95), Lawyers ($59.98 × .5 hours = $29.99), Chief Executives ($89.16 × .5 hours = $44.58), and Computer programmer ($35.32 × 4 hours = $141.28) [Weighted mean = ($110.95 + 29.99 + 44.58 = 

141.28)/7.6 hours = $326.80/7.6 hours = $43.00/hour]. 

Estimated Annual Costs to the Federal 

Government 

Exhibit 3 shows the estimated 

annualized cost to the government for 

developing, maintaining and managing 

the Health Plan Database and analyzing 

the data and reporting results. The cost 

is estimated to be $260,000 annually. 

Annualized costs for collecting and 

processing the CAHPS Health Plan 

Database are based upon 10 years of 

historical project costs. Start-up costs 

were present in the early years of the 

database only. 

EXHIBIT 3—ESTIMATED ANNUALIZED

COST

Cost component Annualized 

cost 

Database Maintenance ......... $50,000 

Data Submission .................. 100,000 

Data Analysis and Reporting 110,000 

Total ............................... 260,000 

Request for Comments 

In accordance with the above-cited 

Paperwork Reduction Act legislation, 

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 healthcare research and 

healthcare 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. 

Dated: March 19, 2010. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2010–6780 Filed 3–30–10; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Proposed Collection: 

Comment Request 

In compliance with the requirement 

for opportunity for public comment on 

proposed data collection projects 

(section 3506(c)(2)(A) of Title 44, United 

States Code, as amended by the 

Paperwork Reduction Act of 1995, Pub. 

L. 104–13), the Health Resources and 

Services Administration (HRSA) 

publishes periodic summaries of 

proposed projects being developed for 

submission to Office of Management 

and Budget (OMB) under the Paperwork 

Reduction Act of 1995. To request more 

information on the proposed project or 

to obtain a copy of the data collection 

plans and draft instruments, call the 

HRSA Reports Clearance Officer on 

(301) 443–1129. 

Comments are invited on: (a) Whether 

the proposed collection of information 

is necessary for the proper performance 

of the functions of the agency, including 

whether the information shall have 

practical utility; (b) the accuracy of the 

agency’s estimate of the burden of the 

proposed collection 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 

on respondents, including through the 

use of automated collection techniques 

or other forms of information 

technology. 

Proposed Project: The Health Education 

Assistance Loan (HEAL) Program: 

Physician’s Certification of Borrower’s 

Total and Permanent Disability Form 

(OMB No. 0915–0204)—Extension 

The Health Education Assistance 

Loan (HEAL) program provided 

federally-insured loans to students in 

schools of allopathic medicine, 

osteopathic medicine, dentistry, 

veterinary medicine, optometry, 

podiatric medicine, pharmacy, public 

health, allied health, or chiropractic, 

and graduate students in health 

administration or clinical psychology 

through September 30, 1998. Eligible 

lenders, such as banks, savings and loan 

associations, credit unions, pension 

funds, State agencies, HEAL schools, 

and insurance companies, made new 

refinanced HEAL loans which are 

insured by the Federal Government 

against loss due to borrower’s death, 

disability, bankruptcy, and default. The 

basic purpose of the program was to 

assure the availability of funds for loans 

to eligible students who needed to 

borrow money to pay for their 

educational loans. Currently, the 

program monitors the federal liability, 

and assists in default prevention 

activities. 

The HEAL borrower, the borrower’s 

physician, and the holder of the loan 

completes the Physician’s Certification 

form to certify that the HEAL borrower 

meets the total and permanent disability 

provisions. The Department uses this 

form to obtain detailed information 

about disability claims which includes 

the following: (1) The borrower’s 

consent to release medical records to the 

Department of Health and Human 

Services and to the holder of the 

borrower’s HEAL loans, (2) pertinent 

information supplied by the certifying 

physician, (3) the physician’s 

certification that the borrower is unable 

to engage in any substantial gainful 

activity because of a medically 

determinable impairment that is 

expected to continue for a long and 

indefinite period of time or to result in 

death, and (4) information from the 


jlentini on DSKJ8SOYB1PROD with NOTICES