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View ICR - OIRA Conclusion

OMB Control No: 0938-1053	ICR Reference No: 201807-0938-002
Status: Historical Active	Previous ICR Reference No: 201504-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: Administrative Requirements for Section 6071 of the Deficit Reduction Act of 2005 (CMS-10249)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/03/2018
	Date Received in OIRA: 09/11/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2021	36 Months From Approved
Responses	352	0	0
Time Burden (Hours)	3,168	0	0
Cost Burden (Dollars)	0	0	0

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	352	-8	-28,215	28,575
Annual Time Burden (Hours)	3,168	408	-11,460	14,220
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: In this 2018 reinstatement the MFP National Evaluation and corresponding data collection activities have concluded and are reflected accordingly (minus 11,460 hours). We have also adjusted our burden based on the withdrawal of one grantee from the MFP Program (plus 408 hours). Overall, our time estimate has decreased by -11,052 hours to 3,168 hours (total).

Annual Cost to Federal Government: $76,310

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: Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov

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