View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0723	ICR Reference No: 200512-0938-004
Status: Historical Active	Previous ICR Reference No: 200208-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare Integrity Program Organizational Conflict of Interest Disclosure Certificate and Supporting Regs at 42 CFR 421.300- 421.316
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/27/2006
	Date Received in OIRA: 12/07/2005
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2009	02/28/2009	02/28/2006
Responses	11	0	5
Time Burden (Hours)	2,200	0	1,000
Cost Burden (Dollars)	0	0	0

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