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:
0935-0206
ICR Reference No:
202508-0935-001
Status:
Active
Previous ICR Reference No:
202203-0935-001
Agency/Subagency:
HHS/AHRQ
Agency Tracking No:
Title:
Online Application Order Form for Products from the Healthcare Cost and Utilization Project (HCUP)
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 with change
Conclusion Date:
12/11/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/10/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2028
36 Months From Approved
Responses
1,800
0
0
Time Burden (Hours)
1,050
0
0
Cost Burden (Dollars)
51,250
0
0
Abstract:
To support AHRQ's mission to improve health care through scientific research, HCUP databases and software tools are disseminated to users outside of the Agency through a mechanism known as the HCUP Central Distributor. The HCUP Central Distributor assists qualified researchers to access uniform research data across multiple states with the use of one application process. The HCUP databases disseminated through the Central distributor are referred to as "restricted access public release files"; that is, they are publicly available, but only under restricted conditions. The HCUP Central Distributor Online Reporting System facilitates the HCUP data users with ordering, purchasing, and re-using HCUP databases, including data applications, requesting complementary databases, submitting data re-use and data sharing requests. The website can be found at: https://cdors.ahrq.gov/ The HCUP Central Distributor User Guide provides detailed instructions on how to purchase, protect, re-use and share the HCUP data. This ICR is for the activities associated with the HCUP database application process not the collection of health care data for HCUP databases. Revisions to this ICR include a redesigned HCUP application form and reducing the number of DUAs to one state and one nationwide version.
Authorizing Statute(s):
US Code:
42 USC 299
Name of Law: Healthcare Research and Quality Act of 1999
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
90 FR 17937
04/30/2025
30-day Notice:
Federal Register Citation:
Citation Date:
90 FR 43611
09/10/2025
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
HCUP Application Form
4, 3, 1, 2
Attachment A- HCUP DUA Agreement Training Course
,
HCUP DUA for the Nationwide Databases
,
HCUP DUA for the State Databases
,
Online application form
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
1,800
0
0
0
0
1,800
Annual Time Burden (Hours)
1,050
0
0
150
0
900
Annual Cost Burden (Dollars)
51,250
0
0
51,250
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:
There have been no changes in public use of the system (i.e., the number of respondents), however there is an increase in the burden hours with this ICR, from 900 to 1,050 hours. This increase in burden is due to a more accurate accounting of the burden associated with the individual steps in the ordering process.
Annual Cost to Federal Government:
$33,648
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.
Yes
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.
Yes
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:
Margie Shofer 301 427-1696 margie.shofer@ahrq.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:
09/10/2025
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