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: 201810-0938-011
Status: Historical Inactive	Previous ICR Reference No: 201708-0938-024
Agency/Subagency: HHS/CMS	Agency Tracking No: 21626
Title: (CMS-10239) Conditions of Participation for Critical Access Hospitals and Supporting Regulations
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 12/03/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/24/2018
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2021	36 Months From Approved	03/31/2021
Responses	118,252	0	118,252
Time Burden (Hours)	24,183	0	24,183
Cost Burden (Dollars)	0	0	0

Authorizing Statute(s): 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
   US Code: 42 USC 1395hh Name of Law: Regulations

Citations for New Statutory Requirements: None

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. 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: Denise King 410 786-1013 Denise.King@cms.hhs.gov