HEALTH MAINTENANCE ORGANIZATION NATIONAL DATA REPORTING REQUIREMENTS

ICR 198009-0937-005

OMB: 0937-0022

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0937-0022 198009-0937-005
Historical Active 197804-0937-001
HHS/OASH
HEALTH MAINTENANCE ORGANIZATION NATIONAL DATA REPORTING REQUIREMENTS
No material or nonsubstantive change to a currently approved collection   No
Emergency 09/29/1980
Approved with change 09/29/1980
Retrieve Notice of Action (NOA) 09/29/1980
  Inventory as of this Action Requested Previously Approved
12/31/1980 12/31/1980 09/30/1980
1,600 0 1,600
2,600 0 2,600
0 0 0

THE DATA COLLECTED IN THIS REPORT IS USED TO ASSESS THE MEMBERSHIP, UTILIZATION AND FINANCIAL STATUS OF OPERATION, QUALIFIED HEALTH MAINTENANCE ORGANIZATIONS FOR THE PURPOSE OF EFFECTIVE LOAN AND COMPLIANCE MONITORING. THE DATA IS ALSO USED TO FULFILL SECTIONS 1315 AND 1318 OF THE PUBLIC HEALTH SERVICE ACT REGARDING THE ANNUAL REPORT TO THE CONGRESS.

None
None


No

1
IC Title Form No. Form Name
HEALTH MAINTENANCE ORGANIZATION NATIONAL DATA REPORTING REQUIREMENTS PHS-6080

  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 1,600 1,600 0 0 0 0
Annual Time Burden (Hours) 2,600 2,600 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/29/1980


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