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OMB Control No: 0915-0151	ICR Reference No: 199105-0915-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: HIV/AIDS DENTAL REIMBURSEMENT PROGRAM
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: 08/02/1991
	Date Received in OIRA: 05/06/1991
Terms of Clearance: This information collection is approved for use through September 30, 1992. Upon its next submission, HHS/CDC shall report on the information/data provided by applicants for reimbursement during the last two years. This shall include all seven of the "Program Requirement" questions. CDC shall not draw conclusions that go beyond the scope of the data collected. CDC cannot draw any conclusions (and therefore base policy changes) about the quality of follow-up care to HIV patients compared to non-HIV patients. More specifically, without any look-back at how individual cases were handled, Questions 4 and 5 do not allow conclusions to be drawn about whether providers are providing less follow-up care to HIV patients or engaging in any other potentially discriminatory action. In short, this data collection is approved with CDC's agreement that the information collected will only be used to make decisions on the appropriateness of reimbursement under this program.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1992	09/30/1992
Responses	150	0	0
Time Burden (Hours)	375	0	0
Cost Burden (Dollars)	0	0	0

Abstract: DENTAL SCHOOLS WILL APPLY FOR REIMBURSEMENT OF DOCUMENTED UNCOMPENSATE COSTS OF ORAL HEALTH CARE FOR HIV INFECTED PERSONS. THE INFORMATION WILL BE USED TO DETERMINE ELIGIBILITY AND AMOUNT OF REIMBURSEMENT UNDE THIS PROGRAM.

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
HIV/AIDS DENTAL REIMBURSEMENT PROGRAM

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	150	150
Annual Time Burden (Hours)	375	375
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

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

View ICR - OIRA Conclusion