View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0778	ICR Reference No: 200311-0938-004
Status: Historical Active	Previous ICR Reference No: 200010-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare + Choice Organization Appeals and Grievance Data Collection and Reporting Requirements. Data Disclosure Requirements 422.111 and 422.564
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/28/2004
	Date Received in OIRA: 11/12/2003
Terms of Clearance: This information collection request is approved with revised burden estimates.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2007	01/31/2007	01/31/2004
Responses	616	0	536
Time Burden (Hours)	438	0	1,608
Cost Burden (Dollars)	0	0	0

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