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:
0938-0334
ICR Reference No:
201810-0938-010
Status:
Historical Inactive
Previous ICR Reference No:
201701-0938-008
Agency/Subagency:
HHS/CMS
Agency Tracking No:
20561
Title:
(CMS-R-38) Medicare and Medicaid Programs: Conditions for Certification for Rural Health Clinics and Conditions for Coverage for FQHCs in 42 CFR 491
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Comment filed on proposed rule and continue
Conclusion Date:
11/09/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/07/2018
Terms of Clearance:
In accordance with 5 CFR 1320, the revision of this information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2020
36 Months From Approved
06/30/2020
Responses
8,656
0
8,656
Time Burden (Hours)
37,216
0
37,216
Cost Burden (Dollars)
0
0
0
Abstract:
This information is needed to determine if rural health clinics and federally qualified health centers meet the requirements to participate in the Medicare Program.
Authorizing Statute(s):
US Code:
42 USC 1395
Name of Law: Social Security Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AT23
Proposed rulemaking
83 FR 47686
09/20/2018
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
8
IC Title
Form No.
Form Name
491.11 - Program Evaluation - Existing FHQCs
491.11 - Program Evaluation - New FQHCs
491.11 - Program Evaluation - New RHCs
491.11 Program Evaluation - Existing RHCs
491.9(b) - Patient Care Policies - Existing FQHCs
491.9(b) Patient Care Policies - Existing RHCs
491.9(b) Patient Care Policies - New FQHCs
491.9(b) Patient Care Policies - New RHCs
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The number of affected RHCs was adjusted from 4,247 to 4,160, hourly wages were updated to reflect the latest (May 2017) data from BLS, staffing requirements and burdens have been adjusted to be what we hope is more realistic, and FQHC burden that was previously unaccounted for has been added. In addition, the reviewing requirements associated with §491.9 and §491.11 have been changed from annual requirements to biennial requirements. Although we have halved our reporting requirements, the adjustments to staffing requirements, and newly accounting for FQHCs in this package, results in an increase in burden from 37,216 hours to 69,270 hours.
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]?
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:
Denise King 410 786-1013 Denise.King@cms.hhs.gov
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:
11/07/2018
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