View Information Collection Request (ICR) Package

View ICR - Agency Submission

Comment Period Closed - Comments are accepted for the first 30 days of OIRA's review. See FAQ page for more information.

OMB Control No:	ICR Reference No: 202606-0906-001
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: 340B Rebate Model Pilot Program Application, Implementation, and Evaluation
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 06/16/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	793,091	0
Time Burden (Hours)	3,965,092	0
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion
Annual Number of Responses	793,091	793,091
Annual Time Burden (Hours)	3,965,092	3,965,092
Annual Cost Burden (Dollars)	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 is the initial clearance request; therefore, there are no changes or adjustments.

Annual Cost to Federal Government: $48,256

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: Catherine Bourassa 301 443-5039 cbourassa@hrsa.gov

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