INFORMATION COLLECTION REQUIREMENTS IN PROSPECTIVE PAYMENT REGULATIONS (B&CR-263) SECTIONS 405.476(B), 405-476(D), 405.1042(C), 405.1627, & 405.1629

ICR 198310-0938-029

OMB: 0938-0308

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0308 198310-0938-029
Historical Active 198308-0938-003
HHS/CMS
INFORMATION COLLECTION REQUIREMENTS IN PROSPECTIVE PAYMENT REGULATIONS (B&CR-263) SECTIONS 405.476(B), 405-476(D), 405.1042(C), 405.1627, & 405.1629
Extension without change of a currently approved collection   No
Regular
Approved without change 12/19/1983
Retrieve Notice of Action (NOA) 10/20/1983
THIS COLLECTION IS APPROVED ON THE CONDITION THAT HCFA REPORT QUARTERL TO OMB THE FOLLOWING INFORMATION FOR EACH HOSPITAL GRANTED AN EXCEPTIO AS A SOLE COMMUNITY PROVIDER: 1. NAME OF THE HOSPITAL 2. BASE YEAR DISCHARGES 3. BED SIZE OF THE HOSPITAL 4. AMOUNT PAID OUT AS A RESULT OF THE EXCEPTION 5. NUMBER OF DISCHARGES WHICH CHANGED FROM THE BASE YEAR THE FOLLOWING INFORMATION COLLECTIONS ARE APPROVED AND INCORPORATED UNDER THIS OMB NUMBER 405.1627 AND 405.1629 [PREVIOUSLY APPROVED UNDER 0938-0306] 405.1042[c] [PREVIOUSLY APPROVED UNDER 0938-0305] 405.476[b] [PREVIOUSLY APPROVED UNDER 0938-0309]
  Inventory as of this Action Requested Previously Approved
12/31/1985 12/31/1985 11/30/1983
375,215 0 215
81,017 0 3,225
0 0 0

UNDER P.L. 98-21 THE SECRETARY CAN GRANT ADDITIONAL PAYMENTS TO SOLE COMMUNITY HOSPITALS DUE TO A DECREASE IN VOLUME OF SERVICE FOR REASONS BEYOND THEIR CONTROL DURING THE TRANSITION PERIOD. REGULATIONS SECTIONS 405.476(B) AND 405.476(D) DETAILS THE REQUIREMENTS WHICH HOSPITALS MUST MEET TO JUSTIFY ADDITIONAL PAYMENTS. THE SOCIAL SECURI ACT REQUIRES THAT PAYMENT FOR CERTAIN COVERED SERVICES MAY BE MADE TO HOSPTAL ONLY IF THE HOSPITAL DEVELOPS & IMPLEMENTS A UTILIZATION REVIE

None
None


No

1
IC Title Form No. Form Name
INFORMATION COLLECTION REQUIREMENTS IN PROSPECTIVE PAYMENT REGULATIONS (B&CR-263) SECTIONS 405.476(B), 405-476(D), 405.1042(C), 405.1627, & 405.1629 HCFA-R-33, R-32, R-31, R-35

  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 375,215 215 0 375,000 0 0
Annual Time Burden (Hours) 81,017 3,225 0 77,792 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.
10/20/1983


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