INFORMATION COLLECTION REQUIREMENTS IN REG. SEC. 405.1627 & 405.1629, PHYSICIAN CERTIFICATION & RECERTIFICATION (PROSPECTIVE PAYMENT REG, BERC-263)

ICR 198308-0938-004

OMB: 0938-0306

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0306 198308-0938-004
Historical Active
HHS/CMS
INFORMATION COLLECTION REQUIREMENTS IN REG. SEC. 405.1627 & 405.1629, PHYSICIAN CERTIFICATION & RECERTIFICATION (PROSPECTIVE PAYMENT REG, BERC-263)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 08/29/1983
Retrieve Notice of Action (NOA) 08/29/1983
  Inventory as of this Action Requested Previously Approved
11/30/1983 11/30/1983
373,644 0 0
78,941 0 0
0 0 0

TITLE XVIII OF THE ACT REQUIRES THAT PAYMENT FOR CERTAIN COVERED SERVICES MAY BE MADE TO A HOSPITAL ONLY IF THERE IS A PHYSICIAN'S CERTIFICATION CONCERNING THE NECESSITY OF THE SERVICES AND, IN CERTAIN INSTANCES, ONLY IF THERE IS A PHYSICIAN'S RECERTIFICATION TO THE CONTINUED NEED FOR SUCH SERVICES.

None
None


No

  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 373,644 0 0 373,644 0 0
Annual Time Burden (Hours) 78,941 0 0 78,941 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.
08/29/1983


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