CONTRACTORS INFORMATION COLLECTIONS - "CLAIMS DEVELOPMENT PHYSICIANS AND OTHER HEALTH CARE PROVIDERS"

ICR 198112-0938-016

OMB: 0938-0233

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0233 198112-0938-016
Historical Active
HHS/CMS
CONTRACTORS INFORMATION COLLECTIONS - "CLAIMS DEVELOPMENT PHYSICIANS AND OTHER HEALTH CARE PROVIDERS"
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/21/1981
Retrieve Notice of Action (NOA) 12/01/1981
  Inventory as of this Action Requested Previously Approved
04/30/1983 04/30/1983
5,600,000 0 0
933,333 0 0
0 0 0

THE INFORMATION IN THIS CATEGORY IS COLLECTED BY CARRIERS AND INTERMEDIARIES FROM PHYSICIANS AND OTHER HEALTH CARE PROVIDERS (THERAPISTS). IT CONCERNS SKILLED NURSING FACILITY LEVEL OF CARE, HOME HEALTH AGENCY AND THERAPY PLANS OF TREATMENT, AND MEDICAL NECESSITY FOR DURABLE MEDICAL EQUIPMENT.

None
None


No

1
IC Title Form No. Form Name
CONTRACTORS INFORMATION COLLECTIONS - "CLAIMS DEVELOPMENT PHYSICIANS AND OTHER HEALTH CARE PROVIDERS" HCFA-9023

  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 5,600,000 0 0 0 5,600,000 0
Annual Time Burden (Hours) 933,333 0 0 0 933,333 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.
12/01/1981


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