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OMB Control No: 0938-0618	ICR Reference No: 202602-0938-001
Status: Received in OIRA	Previous ICR Reference No: 202405-0938-004
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: [Medicaid] Limitations on Provider Related Donations and Health Care Related Taxes; Medicaid and Supporting Regulations in 42 CFR 433.68 and 433.74 (CMS-R-148)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 02/17/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2027
Responses	49	40
Time Burden (Hours)	3,920	3,200
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	49	40	9
Annual Time Burden (Hours)	3,920	3,200	720
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: This iteration is associated with our February 2, 2026 final rule (CMS-2448-F; RIN 0938-AV58) which updates requirements under 42 CFR 433.68 by requiring certain states to undertake one-time actions to address issues concerning existing tax waivers that will no longer be permissible. Overall, the provision adds 720 hours of burden with a state share of $16,877. This collection of information request does not provide any reporting instruments or instructions outside of what is in the cited rules and what is codified in the CFR.

Annual Cost to Federal Government: $104,002

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: Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov

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