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: 0938-0679	ICR Reference No: 200303-0938-007
Status: Historical Active	Previous ICR Reference No: 200207-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Durable Medical Equipment Regional Carrier, Certificate of Medical Necessity and Supporting Documentation
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/06/2003
	Date Received in OIRA: 03/21/2003
Terms of Clearance: This information collection request is approved for 18 months, as amended by CMS. As agreed, CMS will revise Chapter 3 of its program integrity manual to incorporate language that describes the circumstances under which it may request supplementary information from respondents to support the CMN.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2004	12/31/2004	06/30/2003
Responses	6,800,000	0	6,700,000
Time Burden (Hours)	1,530,000	0	1,130,000
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	6,800,000	6,700,000	42,500	57,500
Annual Time Burden (Hours)	1,530,000	1,130,000	170,000	230,000
Annual Cost Burden (Dollars)	0	0	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:

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