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View ICR - OIRA Conclusion

OMB Control No: 0938-1019	ICR Reference No: 202512-0938-011
Status: Active	Previous ICR Reference No: 202212-0938-017
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Hospital Notices: IM / DND (CMS-10065/10066)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/10/2026
	Date Received in OIRA: 12/16/2025
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2029	36 Months From Approved	03/31/2026
Responses	25,397,156	0	14,087,086
Time Burden (Hours)	4,313,823	0	2,385,108
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	25,397,156	14,087,086	11,310,070
Annual Time Burden (Hours)	4,313,823	2,385,108	1,928,715
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: CMS estimates a burden increase due to the growth in hospitals and CAHs delivering approximately 25.4 million notices annually (25.3 million IMs + 97,156 DNDs). This represents an increase of around 11 million from our last collection. This is due to our recent capacity to capture Medicare Advantage data in addition to Original Medicare.

Annual Cost to Federal Government: $1,572

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

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