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View ICR - OIRA Conclusion

OMB Control No: 0938-1088	ICR Reference No: 201108-0938-002
Status: Historical Active	Previous ICR Reference No: 201103-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: State Medicaid HIT Plan (SMHP) and Template for Implementation of Section 4201 of ARRA (CMS-10292)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/23/2011
	Date Received in OIRA: 08/16/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2014	36 Months From Approved	04/30/2014
Responses	56	0	56
Time Burden (Hours)	896	0	280
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	56	56	0
Annual Time Burden (Hours)	896	280	616
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 annual hour burden has increased from 280 hr to 896 hr based on the addition of the IAPD template.

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