View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0915-0363
ICR Reference No:
201603-0915-001
Status:
Historical Active
Previous ICR Reference No:
201305-0915-001
Agency/Subagency:
HHS/HSA
Agency Tracking No:
19326
Title:
Medicare Rural Hospital Flexibility Grant Program Performance Measures
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:
06/09/2016
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/03/2016
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2019
36 Months From Approved
07/31/2016
Responses
45
0
45
Time Burden (Hours)
3,150
0
9,720
Cost Burden (Dollars)
0
0
0
Abstract:
The Flex program supports state designated entities that assist critical access hospitals (CAHs) improve across Flex initiatives. These initiatives are meant to ensure residents in rural communities have access to high quality health care services. These initiatives cover the following principal topic areas: quality reporting and improvement; financial and operational improvement; population health management; Emergency Medical Service (EMS) Integration; critical access hospital (CAH) conversion; and Integration of Innovative Care Models. Flex program performance measures were drafted, and approved with stakeholder feedback to aggregate program data required by Congress under the Government Performance and Results Act (GPRA) of 2010. Such data is also of interest to the Federal Office of Rural Health Policy (FORHP) and Flex Program for identifying and understanding programmatic improvement across initiatives, prioritizing areas of need, targeting technical support, and guiding future iterations of the Flex Program.
Authorizing Statute(s):
US Code:
42 USC 711
Name of Law: Social Security Act
PL:
Pub.L. 111 - 352 2142
Name of Law: GPRA Modernization Act of 2010
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
80 FR 101
05/27/2015
30-day Notice:
Federal Register Citation:
Citation Date:
81 FR 30
02/16/2016
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Medicare Rural Hospital Flexibility Grant Program Performance Measures
1
1
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
45
45
0
0
0
0
Annual Time Burden (Hours)
3,150
9,720
0
-6,570
0
0
Annual Cost Burden (Dollars)
0
0
0
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:
Yes
Burden Reduction Due to:
Changing Forms
Short Statement:
The measures have been revised and the burden to respondents has been reduced.
Annual Cost to Federal Government:
$9,720
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Lisa Wright-Solomon 3014430985
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
03/03/2016
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