View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-1102	ICR Reference No: 201307-0938-023
Status: Historical Active	Previous ICR Reference No: 200910-0938-012
Agency/Subagency: HHS/CMS	Agency Tracking No: 20156
Title: Medicare Quality of Care Complaint Form
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: 11/21/2013
	Date Received in OIRA: 07/30/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2016	36 Months From Approved	11/30/2013
Responses	3,500	0	3,500
Time Burden (Hours)	583	0	583
Cost Burden (Dollars)	0	0	0

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