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: 0938-1390	ICR Reference No: 202506-0938-005
Status: Active	Previous ICR Reference No: 202402-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No: OIT
Title: Administrative Simplification HIPAA Compliance Review (CMS-10662)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/05/2026
	Date Received in OIRA: 06/18/2025
Terms of Clearance: Approved with the understanding that CMS will seek to streamline and lower the paperwork burden for this collection, by ensuring every data element being collected has a use.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2029	36 Months From Approved	03/31/2026
Responses	140	0	60
Time Burden (Hours)	3,040	0	1,000
Cost Burden (Dollars)	0	0	0

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Compliance Review	CMS-10662, CMS-10662, CMS-10662, CMS-10662, CMS-10662	, , , ,
Structuring and monitoring the CAP	CMS-10662, CMS-10662	,

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	140	60	80
Annual Time Burden (Hours)	3,040	1,000	2,040
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: No

Burden Reduction Due to:

Short Statement: Burden has increased due to the growth of reviews that are conducted annually. CMS has expanded the program to up to 100 entities annually. CMS has also made the following updates to communications sent to covered entities since the last PRA request; however, there are no changes to data/information collection requests:

Annual Cost to Federal Government: $3,224

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: Stephan McKenzie 410 786-1943 stephan.mckenzie@cms.hhs.gov

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