View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Information Collection Requirements Referenced in HIPAA for the Group Market, Supporting Regulations 45 CFR 146, and forms/instructions (CMS-R-206)
 
No Modified
 
Mandatory
 
45 CFR 146.111 45 CFR 146.115 45 CFR 146.117 45 CFR 146.150 45 CFR 146.152 45 CFR 146.160 45 CFR 146.180

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Letter Yes Yes Paper Only
Other-Letter Yes Yes Paper Only
Other-Letter Yes Yes Paper Only

Health Health Care Services

 

7,400 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 36,902,550 0 0 -99,667 0 37,002,217
Annual IC Time Burden (Hours) 2,918,783 0 0 2,472,104 0 446,679
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
R-206 Opt Out Model Language 06/26/2009
R-206 Respondents Burden Hours Version2 06/26/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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