National Ambulatory Medical Care Survey

OMB Control No: 0920-0234	ICR Reference No: 201211-0920-001
Status: Historical Active	Previous ICR Reference No: 201111-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Ambulatory Medical Care Survey
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/07/2012
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/01/2012
Terms of Clearance: Proir terms continue: New modules must be submitted to OMB for approval as substantive changes unless they were covered in the original supporting statement (e.g., moving prior modules in; cycling current modules out).

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	12/31/2014	12/31/2014
Responses	571,530	0	528,615
Time Burden (Hours)	50,923	0	46,622
Cost Burden (Dollars)	0	0	0

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Abstract: The National Ambulatory Medical Care Survey includes data collected from office-based physicians, and community health center providers. The National Electronic Health Records Survey (NEHRS), and the Physician Workflow Survey are also part of this project. . Several questions will be modified on physician information and on data on electronic medical records and physicians who have/have not adopted the use of these records.

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Authorizing Statute(s): US Code: 42 USC 242K Name of Law: Public Health Service Act    PL: Pub.L. 111 - 5 1512 Name of Law: American Recovery and Reinvestment Act of 2009

Citations for New Statutory Requirements: None

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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

Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 11

IC Title Form No. Form Name NAMCS-1 Physician Induction Interview (Line 1) None National Ambulatory Medical Care Survey 2013 Panel NAMCS-201 Community Health Center Induction Interview (Line 2) none Att K - Community Health Center Induction Interview NAMCS-30 Patient Record form (Line 3) None National Ambulatory Medical Care Survey 2013 Medical Record Form Pulling and re-filing Patient Record form (Line 4) Lookback Module (Line 5) None National Ambulatory Medical Care Survey 2013 Look Back Module 2012 Asthma Supplement (line 6) none Att B - Asthma Supplement National Electronic Health Records Survey (line 7) None National Electronic Health Records Survey 2013 Physician Workflow Survey (line 8) None, None E. Physician Workflow Survey Year 2013 (EHR adopters) ,   F. Physician Workflow Survey Year 2013 (EHR nonadopters) 2012 CPT Pretest NAMCS-1 (line 9) none Att Z - NAMCS 2011 Panel CPT Code Pretest 2012 Pretest NAMCS Patient Record Form (line 10) none Att BB - NAMCS 2012 - Patient Record Form CPT Code Pretest Re-abstraction Study

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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	571,530	528,615	0	42,915	0	0
Annual Time Burden (Hours)	50,923	46,622	0	4,301	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This document proposes some new, reinstated, and modified questions to the prior approved NAMCS data collection content by survey form. New and modified content for 2013 is presented in the included attachments highlighted below and described in more detail in section A2.

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Annual Cost to Federal Government: $11,399,149

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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)? Yes

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Petunia Gissendaner 4046390164

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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: 11/01/2012

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