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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-0279
ICR Reference No:
199309-0938-005
Status:
Historical Active
Previous ICR Reference No:
199303-0938-009
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
MEDICAR UNIFORM INSTITUTIONAL PROVIDER BILL
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:
12/06/1993
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/07/1993
Terms of Clearance:
OMB shares the public commenters' commitment to ensuring adequate collection, analysis, and dissemination of race/ethnicity data for the purposes of enforcement of Title VI of the Civil Rights Act of 1965 an creation of a baseline for evaluating access to health care services. Furthermore, OMB believes analysis of access issues will be particular critical in the context of future implementation of Health Care Reform However, after thoughtful consideration of public comments and input from HCFA and SSA, OMB has determined that inclusion of race/ethnicity data on the UB-92 would not be the most effective means of ensuring adequate data collection, analysis, and dissemination. Accordingly, O approves for use the UB-92 as submitted until 6/94 under the condition that HCFA: 1) in consultation with SSA, the Office of Civil Rights, an ASPE immediately pursues planned initiatives as described under the headings "Current Joint HCFA and SSA Initiatives to Improve HCFA Race Data" and the "Medicaid Race Code Situation" in the enclosed HCFA/SSA Discussion Paper dated 12/3/93; 2) in consultation with the previously mentioned Offices, develops a long term strategy for enhancing the collection, analysis, and dissemination of race/ethnicity data and includes this strategy in the next submission for OMB review; and 3) n later than 3/94, provides OMB with a status report on progress in im- plementing immediate, short term initiatives and in developing the lon term data strategy.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/1994
06/30/1994
06/30/1995
Responses
170,000,000
0
70,000,000
Time Burden (Hours)
6,235,500
0
6,235,500
Cost Burden (Dollars)
0
0
0
Abstract:
THESE HOSPITAL BILLING REQUIREMENTS ENABLE THE MEDICAID PROGRAM TO DEVELOP MEANINGFUL DATA FOR USE BY THE FEDERAL GOVERNMENT IN ORDER TO REDUCE MEDICAL CARE COST. THIS FORM IMPROVES COMPATIBILITY IN HOSPITA CLAIM FILING FOR THE MEDICAID AND MEDICARE PROGRAMS AND SIMPLIFIES CLAIMS FOR PROVIDERS.
Authorizing Statute(s):
None
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
MEDICAR UNIFORM INSTITUTIONAL PROVIDER BILL
HCFA-1450
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
170,000,000
70,000,000
0
100,000,000
0
0
Annual Time Burden (Hours)
6,235,500
6,235,500
0
0
0
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:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
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]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Common Form ICR:
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:
(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:
09/07/1993
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