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View ICR - OIRA Conclusion

OMB Control No: 0938-0676	ICR Reference No: 201407-0938-009
Status: Historical Active	Previous ICR Reference No: 201107-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Reconciliation of State Invoice and Prior Quarter Adjustment Statement (CMS-304/304a)
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: 09/30/2014
	Date Received in OIRA: 07/22/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	36 Months From Approved	10/31/2014
Responses	4,148	0	4,044
Time Burden (Hours)	187,880	0	183,120
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	4,148	4,044	104
Annual Time Burden (Hours)	187,880	183,120	4,760
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: For PQAS, the number of labelers has been adjusted from 595 to 610 due to the increase in labeler participation. Similarly, the number of labelers for ROSI has been adjusted to 427 or 70 percent of 610. While the time per response remains unchanged, the total hours and cost have been adjusted to reflect the revised number of labelers.

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