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 Generic ICR - OIRA Conclusion

OMB Control No: 0938-1148	ICR Reference No: 201111-0938-009
Status: Historical Active	Previous ICR Reference No: 201109-0938-004
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions
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: 11/28/2011
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/22/2011
Terms of Clearance: Approved consistent with the understanding that individual collections (GenICs) will be submitted for review and approval prior to initiating those collections. Approval for this generic ICR should not be construed as approval for this particular IC.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2014	10/31/2014	10/31/2014
Responses	3,360	0	1,120
Time Burden (Hours)	86,240	0	28,747
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	3,360	1,120	2,240
Annual Time Burden (Hours)	86,240	28,747	57,493
Annual Cost Burden (Dollars)	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: The burden that was requested and subsequently approved set out the annual burden when it should have set out the total 3-year burden. Consequently, we request that the number of Responses is corrected to read "3,360" and the Hour burden is corrected to read "86,240." These changes will not affect our burden estimates since those estimates were set out in the ICR's Supporting Statement.