Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
42 CFR 411.362(b)(3)(ii)(A) and 489.20(u)(2) - Medical Staff by-Laws and Policies (Attorney) Modified 8 16 0
42 CFR 411.362(b)(3)(ii)(C) Website/Public Advertising Disclosure Modified 81 41 0
42 CFR 411.362(b)(5)(i) - Disclosures Modified 291416 7284 0
42 CFR 489.20(u)(1) - (5) - Disclosure of physician owners/investors Modified 162 162 0
42 CFR 489.20(u)(1) - Attestation of non-Referring Status (Attorney) Modified 81 81 0
42 CFR 489.20(u)(1) - Create Disclosure Modified 8 32 0
42 CFR 489.20(u)(1) - Disclosure of Physician Owners/Investors to Patients Removed 0 0 0
42 CFR 489.20(u)(1) - Inpatient Disclosure Modified 206550 3442 0
42 CFR 489.20(u)(1) - Outpatient Disclosure Modified 1659366 27656 0
42 CFR 489.20(w)(1)- (5)- Disclosure of Physician Owners/Investors to Staff Physicians Modified 5711616 142791 0
Total burden requested under this ICR: 7869288 181505 0  
To view an IC, click on IC Title