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: 200708-0960-007
Status: Historical Active	Previous ICR Reference No: 200704-0960-001
Agency/Subagency: SSA	Agency Tracking No:
Title: Medicare Subsidy Quality Review Case Analysis, 20 CFR 418(b)(5)
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: 11/02/2007
	Date Received in OIRA: 09/18/2007
Terms of Clearance: This ICR is approved consistent with revisions made to forms SSA-9313 and SSA-9314. This ICR is also approved on the understanding that none of the other ICs in this collection are being modified from what was previously approved. Therefore, previous terms of clearance remain in effect.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2010	36 Months From Approved	04/30/2009
Responses	74,500	0	69,500
Time Burden (Hours)	18,625	0	17,375
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	74,500	69,500	5,000
Annual Time Burden (Hours)	18,625	17,375	1,250
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden for this ICR is increasing due to the addition of two new forms.

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