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: 0938-1071	ICR Reference No: 202405-0938-029
Status: Active	Previous ICR Reference No: 201911-0938-005
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Ambulatory Surgical Centers Conditions of Coverage (CMS-10279)
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: 07/31/2024
	Date Received in OIRA: 06/06/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2027	36 Months From Approved
Responses	12,739	0	0
Time Burden (Hours)	97,527	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	12,739	-9,546	22,285
Annual Time Burden (Hours)	97,527	-165,419	262,946
Annual Cost Burden (Dollars)	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Changes to the burden are a reflection of three changes: 1) A correction in the assumption in the previous iteration that development (IC-1) of notifications and draft policy (IC-3) occur more than a one-time basis and 2) an increase in the number of affected ASCs from 5,557 to 6,227. These changes and updates result in a 170 percent net decrease in annual burden hours, from 262,946 to 97,527 and a 154 percent net decrease in annual cost, from $28,144,370 to $11,089,427.

Annual Cost to Federal Government: $2,008,208

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? No

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

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