View Information Collection Request (ICR) Package

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: 0938-0202	ICR Reference No: 199206-0938-007
Status: Historical Active	Previous ICR Reference No: 199107-0938-008
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: HOME OFFICE COST STATEMENT
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/14/1992
	Date Received in OIRA: 06/17/1992
Terms of Clearance: Approved for use through 3/93 under the condition that OMB clearance remarks dated 1/2/90 are complied with or at a minimum addressed in the supporting statement of the next clearance package. The remarks dated 1/2/90 stated the following: "Approved for use . . . under the condition that the next submission for OMB approval includes representative sample of alternative home office cost statements and respective instructions accepted and used by HCFA contractors."

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/1993	03/31/1993	10/31/1992
Responses	1,231	0	850
Time Burden (Hours)	573,646	0	117,300
Cost Burden (Dollars)	0	0	0

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