View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-1035	ICR Reference No: 201311-0938-007
Status: Historical Active	Previous ICR Reference No: 200801-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No: 20872
Title: Provider Enrollment Chain and Ownership System (PECOS) Web Security Consent Form
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 without change	Conclusion Date: 02/14/2014
	Date Received in OIRA: 11/08/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	36 Months From Approved
Responses	88,650	0	0
Time Burden (Hours)	22,163	0	0
Cost Burden (Dollars)	0	0	0

Authorizing Statute(s): US Code: 42 USC 1395f(a) Name of Law: CONDITIONS OF AND LIMITATIONS ON PAYMENT FOR SERVICES
   US Code: 42 USC 1395g(a) Name of Law: PAYMENT TO PROVIDERS OF SERVICES
   US Code: 42 USC 1395l(e) Name of Law: PAYMENT OF BENEFITS
   US Code: 42 USC 1395m(j) Name of Law: SPECIAL PAYMENT RULES FOR PARTICULAR ITEMS AND SERVICES
   US Code: 42 USC 1395u(u) Name of Law: PROVISIONS RELATING TO THE ADMINISTRATION OF PART B
   US Code: 42 USC 1395u(r) Name of Law: PROVISIONS RELATING TO THE ADMINISTRATION OF PART B
   US Code: 42 USC 1395cc(j)(1)(C) Name of Law: AGREEMENTS WITH PROVIDERS OF SERVICES; ENROLLMENT PROCESSES
   PL: Pub.L. 105 - 33 4313 Name of Law: The Balanced Budget Act of 1997
   PL: Pub.L. 104 - 134 31001(I) Name of Law: Debt Collection Improvement Act of 1996

Citations for New Statutory Requirements: None

ICR Summary of Burden

	Total Approved	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	88,650	-88,850	177,500
Annual Time Burden (Hours)	22,163	-22,212	44,375
Annual Cost Burden (Dollars)	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: The burden has been adjusted and the form has been condensed from two forms into one.

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