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View ICR - OIRA Conclusion

OMB Control No: 0938-0953	ICR Reference No: 201108-0938-004
Status: Historical Active	Previous ICR Reference No: 200805-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Notice of Provider Non-Coverage (CMS-10123) and Detailed Explanation of Non-Coverage (CMS-10124)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/12/2011
	Date Received in OIRA: 08/25/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	36 Months From Approved
Responses	5,339,849	0	0
Time Burden (Hours)	927,931	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	5,339,849	2,224,212	3,115,637
Annual Time Burden (Hours)	927,931	405,793	522,138
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: Our revised methodology for calculating the NOMNC burden is responsible for the increase in our estimated managed care burden. We now calculate the managed care NOMNC burden based on the actual number of HHA and SNF services and discharges. This is consistent with how we have calculated the burden for Original Medicare NOMNCs in the previous two OMB collections. In addition, we are now including SNF data in our calculations for Original Medicare. This increases our burden by 2 million NOMNCs.

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