INFORMATION COLLECTION REQUIREMENTS IN 42 CFR 405.460 EXCEPTIONS TO COST LIMITS

ICR 198503-0938-006

OMB: 0938-0337

Federal Form Document

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Document
Name
Status
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ICR Details
0938-0337 198503-0938-006
Historical Active 198312-0938-015
HHS/CMS
INFORMATION COLLECTION REQUIREMENTS IN 42 CFR 405.460 EXCEPTIONS TO COST LIMITS
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 04/29/1985
Retrieve Notice of Action (NOA) 03/21/1985
  Inventory as of this Action Requested Previously Approved
12/31/1987 12/31/1987
100 0 0
400 0 0
0 0 0

42 CFR 405.460 CONTAINS GENERAL INFORMATION REQUIREMENTS FOR HEALTH CARE PROVIDERS SEEKING AN EXCEPTION TO MEDICARE COST LIMITS. THE HEAL CARE FINANCING ADMINISTRATION USES THE INFORMATION TO DETERMINE WHETHE THE PROVIDER IS SUBJECT TO DEFINED UNUSUAL CIRCUMSTANCES UNDER WHICH EXCEPTIONS ARE JUSTIFIED.

None
None


No

1
IC Title Form No. Form Name
INFORMATION COLLECTION REQUIREMENTS IN 42 CFR 405.460 EXCEPTIONS TO COST LIMITS HCFA-R-41

  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 100 0 0 100 0 0
Annual Time Burden (Hours) 400 0 0 400 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.
03/21/1985


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