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: 0938-0691	ICR Reference No: 199607-0938-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare Disproportionate Share Adjustment Procedures and Criteria
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: 10/11/1996
	Date Received in OIRA: 07/19/1996
Terms of Clearance: Approved for use through 10/99 with one observation. OMB commends HCFA for submitting this package for OMB clearance, but remains concerned that the requirements have been effect since September 1, 1995. OMB reminds HCFA that in the future it should ensure that all information collection and recordkeeping requirements have PRA clearance before they are made effective.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/1999	10/31/1999
Responses	100	0	0
Time Burden (Hours)	100	0	0
Cost Burden (Dollars)	0	0	0

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