View Information Collection Request (ICR) Package
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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:
0938-0345
ICR Reference No:
198401-0938-001
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
STATISTICAL REPORT ON MEDICAL CARE: RECIPIENTS, PAYMENTS AND SERVICES
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/22/1984
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/31/1984
Terms of Clearance:
THIS COLLECTION IS APPROVED AS FOLLOWS: 1. THE HARD COPY VERSION OF THE HCFA 2082 IS APPROVED FOR USE THRU APRIL 1985 BEGINNING WITH THE FY 1984 REPORTING PERIOD. THIS EXPIRA TION DATE MUST APPEAR ON THE PRINTED FORMS. HCFA SHALL ASSESS THIS TO DETERMINE THE CONTINUED UTILITY OF COLLECTING THIS OR OTHER DATA FOR PROGRAM MANAGEMENT OR POLICY MAKING PURPOSES. 2. THE MMIS TAPE SAMPLE VERSION OF THE HCFA 2082 IS APPROVED FOR USE THRU FEBRUARY 1987 BEGINNING WITH THE FY 1984 REPORTING PERIOD PROVIDING THE FOLLOWING CONDITIONS ARE MET: A. THE FINAL VERSION OF THE MMIS TAPE SAMPLE WITH A COMPILATION OF THE STATE COMMENTS IS SUBMITTED TO OMB FOR APPROVAL BY APRIL 9. B. THE FINAL VERSION OF THE MMIS TAPE SAMPLE AND INSTRUCTIONS ARE SENT TO MEDICAID STATE AGENCIES NO LATER THAN APRIL 16, 1984. C. DRAFTS OF THE FORMAL ACTION TRANSMITTAL AND MANUAL REVISIIONS ARE SUBMITTED TO OMB FOR APPROVAL BY JUNE 1, 1984, AND ARE MAILED TO STATE MEDICAID AGENCIES BY JUNE 15, 1984. 3. THE FY 1983 VERSION OF THE HCFA 2082 IS APPROVED FOR USE BY THOSE STATE MEDICAID AGENCIES WHICH ELECT TO REPORT VIA THE MMIS TAPE SAMPLE BUT ARE UNABLE TO DO SO FOR THE FY 1984 REPORTING PERIOD. 4. HCFA SHALL SUBMIT NEW BURDEN CALCULATIONS TO OMB BY JUNE 1, 1984.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/28/1987
02/28/1987
Responses
55
0
0
Time Burden (Hours)
21,039
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
THIS DATA IS NEEDED TO MONITOR PAST AND PROJECTED FUTURE TRENDS IN THE MEDICAID PROGRAM. IT IS USED AS THE BASIS OF THE ANALYSIS AND COST SAVING ESTIMATES FOR COST SHARING LEGISLATION INITIATIVES TO CONGRESS. ANOTHER IMPORTANT USE CENTERS ON HCFA'S/HHS ACTUARIAL FORECAST. THE RESPONDENTS ARE MEDICAID STATE AGENCIES.
Authorizing Statute(s):
None
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
STATISTICAL REPORT ON MEDICAL CARE: RECIPIENTS, PAYMENTS AND SERVICES
HCFA-2082
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
55
0
0
0
55
0
Annual Time Burden (Hours)
21,039
0
0
0
21,039
0
Annual Cost Burden (Dollars)
0
0
0
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:
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]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
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:
01/31/1984
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