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View ICR - OIRA Conclusion

OMB Control No: 0938-0251	ICR Reference No: 201012-0938-021
Status: Historical Active	Previous ICR Reference No: 200708-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Application for Hospital Insurance
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 without change	Conclusion Date: 03/14/2011
	Date Received in OIRA: 12/30/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2014	36 Months From Approved	03/31/2011
Responses	50,000	0	50,000
Time Burden (Hours)	12,495	0	12,495
Cost Burden (Dollars)	0	0	0

Authorizing Statute(s): US Code: 42 USC 426 Name of Law: Entitlement to Hospital Insurance Benefits
   US Code: 42 USC 427 Name of Law: Transitional Insured Status
   US Code: 42 USC 1395i-2a Name of Law: Hospital Insurance Benefits for Disabled Individuals Who Have Exhausted Other Entitilements
   US Code: 42 USC 1935i-2 Name of Law: Hospital Insurance Benefits for Uninsured Elderly Individuals not Otherwise Eligible
   PL: Pub.L. 42 - 406 10 Name of Law: Hospital Insurance Eligibility and Entitlement
   PL: Pub.L. 42 - 406 11 Name of Law: Individual age 65 or over who is not eligible as a social security or railroad retirement benefits
   PL: Pub.L. 42 - 406 20 Name of Law: Premium Hospital Insurance - Basic Requirements
   PL: Pub.L. 42 - 406 6 Name of Law: Application or enrollment for hospital insurance
   PL: Pub.L. 42 - 406 7 Name of Law: Forms to apply for entitlement under Medicare Part A

Citations for New Statutory Requirements: None

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