View Information Collection Request (ICR) Package

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: 0938-0676	ICR Reference No: 201704-0938-010
Status: Historical Active	Previous ICR Reference No: 201407-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: Reconciliation of State Invoice (ROSI) and Prior Quarter Adjustment Statement (PQRS) (CMS-304 and CMS-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: 06/19/2017
	Date Received in OIRA: 04/28/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	36 Months From Approved	09/30/2017
Responses	4,468	0	4,148
Time Burden (Hours)	202,384	0	187,880
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	4,468	4,148	320
Annual Time Burden (Hours)	202,384	187,880	14,504
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: This package does not propose any program changes. All forms are unchanged. The total number of annual burden hours increased for both forms due to an increase in the number of respondents (manufacturer participation increased from 610 to 657). The time per response is unchanged. Overall, the burden has increased by 14,504 hours (from 187,880 hr to 202,384 hr). Cost estimates also increased due to the increase in manufacturer participation, and because the previous PRA package inconsistently reflected cost estimates, and did not designate specific BLS occupational titles and hours to the burden estimates. This iteration proposes to correct those omissions by setting out the time and cost estimates for each of the occupational titles.

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.