EVALUATION OF THE OKLAHOMA UTILIZATION REVIEW SYSTEM

ICR 198009-0938-005

OMB: 0938-0136

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
112938 Migrated
ICR Details
0938-0136 198009-0938-005
Historical Active
HHS/CMS
EVALUATION OF THE OKLAHOMA UTILIZATION REVIEW SYSTEM
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/05/1980
Retrieve Notice of Action (NOA) 09/10/1980
  Inventory as of this Action Requested Previously Approved
03/31/1981 03/31/1981
228 0 0
969 0 0
0 0 0

THIS IS A ONE-TIME STUDY TO EVALUATE THE EFFECT OF THE OKLAHOMA UTILIZATION REVIEW SYSTEM (OURS) ON HOSPITAL UTILIZATION AND RUALITY OF CARE IN THAT STATE. THE STUDY WILL COMPARE OURS RESULTS WITH CURRENT PSRD REVIEW RESULTS.

None
None


No

1
IC Title Form No. Form Name
EVALUATION OF THE OKLAHOMA UTILIZATION REVIEW SYSTEM HCFA-214,, 214A, 215,, & 215A

  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 228 0 0 228 0 0
Annual Time Burden (Hours) 969 0 0 969 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
09/10/1980


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