View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0976	ICR Reference No: 200509-0938-016
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Notice of Denial of Medicare Prescription Drug Coverage
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 with change	Conclusion Date: 11/22/2005
	Date Received in OIRA: 09/30/2005
Terms of Clearance: The agency will submit any changes to the burden estimate as it gains program experience to enable it to more accurately estimate the burden associated with this collection.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2008	11/30/2008
Responses	1,056,000	0	0
Time Burden (Hours)	528,000	0	0
Cost Burden (Dollars)	53,000	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	1,056,000	1,056,000
Annual Time Burden (Hours)	528,000	528,000
Annual Cost Burden (Dollars)	53,000	53,000

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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