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: 0960-0707	ICR Reference No: 200507-0960-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Medicare Subsidy Quality Review Case Analysis
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 07/15/2005
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/18/2005
	Date Received in OIRA: 07/06/2005
Terms of Clearance: The information collection is approved with the following terms o of clearance. The agency will provide a status briefing on this program to OMB 2 weeks after the program is initated and monthly thereafter until the end of CY05.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2005	12/31/2005
Responses	59,000	0	0
Time Burden (Hours)	16,416	0	0
Cost Burden (Dollars)	0	0	0

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Medicare Subsidy Quality Review Case Analysis	SSA-9301, SSA-9302, SSA-9303, SSA-9308, SSA-9309, SSA-8510

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