View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-1264	ICR Reference No: 201412-0938-005
Status: Historical Active	Previous ICR Reference No: 201412-0938-004
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Health Plan Monitoring System Level I and Level II Data Entry for the Program of all-Inclusive Care for the Elderly (CMS-10525)
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: 12/17/2014
	Date Received in OIRA: 12/16/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2017	36 Months From Approved	12/31/2017
Responses	64,000	0	24,000
Time Burden (Hours)	46,000	0	6,000
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute
Annual Number of Responses	64,000	24,000	40,000
Annual Time Burden (Hours)	46,000	6,000	40,000
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: Adds Level II monitoring data entry. No changes to Level I data entry.

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