View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-1067	ICR Reference No: 201803-0938-001
Status: Historical Active	Previous ICR Reference No: 201406-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Hospice Conditions of Participation (CMS-10277)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/14/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/16/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2021	36 Months From Approved
Responses	20,992,646	0	0
Time Burden (Hours)	3,749,351	0	0
Cost Burden (Dollars)	0	0	0

Authorizing Statute(s): US Code: 42 USC 1395x Name of Law: Hospice Care; Hospice Program
   PL: Pub.L. 97 - 248 122 Name of Law: Tax Equity & Fiscal Responsibility Act
   PL: Pub.L. 101 - 239 6005(b) Name of Law: Omnibus Reconciliation Act of 1989
   PL: Pub.L. 105 - 33 Title IV, Chapter 4 Name of Law: BBA of 1997
   PL: Pub.L. 108 - 173 946 Name of Law: Medicare Prescription Drug, Improvement, & Modernization Act of 2003

Citations for New Statutory Requirements: US Code: 42 USC 1395x Name of Law: Hospice Care; Hospice Program

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	20,992,646	18,128	1,690,029	19,284,489
Annual Time Burden (Hours)	3,749,351	1,511	505,560	3,242,280
Annual Cost Burden (Dollars)	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The total annual hourly burden for the information collection requirements is estimated to be 3,749,351 hours. The 507,071 hours hour increase is due to two main factors. First, the number of Medicare-certified hospices has increased by 576 hospices, from 3,897 to 4,473. Second, the number of patients receiving hospice services has increased 51,608 patients, from 1, 535,919 to 1,587,527 (1,428,775 Medicare Beneficiaries and 158,752 non-Medicare Beneficiaries).

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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: Denise King 410 786-1013 Denise.King@cms.hhs.gov