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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:
0938-1043
ICR Reference No:
201011-0938-004
Status:
Historical Active
Previous ICR Reference No:
200802-0938-003
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
Conditions of Participation for Critical Access Hospitals and Supporting Regulations in 42 CFR 485.23, 485.618, 485.618, 485.631, 485.635, 485.641, 485.643, 485.645
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
03/14/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/02/2010
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2014
36 Months From Approved
06/30/2011
Responses
143,994
0
142,680
Time Burden (Hours)
23,615
0
23,286
Cost Burden (Dollars)
0
0
0
Abstract:
With this submission, we are revising the PRA package for critical access hospitals (CAHs) to include the new requirement associated with 42 CFR 485.635(f).
Authorizing Statute(s):
US Code:
42 USC 1395hh
Name of Law: Regulations
US Code:
42 USC 1395aa
Name of Law: Use of State Agencies to determine compliance by providers of services with CoPs
US Code:
42 USC 1395x(e) and (mm)
Name of Law: Part E - Miscellaneous Provisions
US Code:
42 USC 1395(a)(8)
Name of Law: Conditions of and Limitations on Payment for Services
US Code:
42 USC 1320b-8
Name of Law: Hospital Protocols for Organ Procurement and Standards for Organ Procurement Agencies
US Code:
42 USC 1302
Name of Law: Rules and Regulations
US Code:
42 USC 1395i-4(a-f)
Name of Law: Medicare Rural Hospital Flexibility Program
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AQ06
Final or interim final rulemaking
75 FR 70831
11/19/2010
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
8
IC Title
Form No.
Form Name
42CFR485.618
42CFR485.623(d)(4)
42CFR485.631
42CFR485.635(c)(3)
42CFR485.635(f)
42CFR485.641
42CFR485.643(a-b)
42CFR485.645(d)
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
143,994
142,680
0
1,314
0
0
Annual Time Burden (Hours)
23,615
23,286
0
329
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:
We are revising the collection to account for new burden associated with requirements in 42 CFR 485.635(f).
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]?
No
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)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
William Parham 4107864669
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:
11/02/2010
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