Information Collection

Medicare, Medicaid, And Clinical Laboratories Improvement Act (clia) Patient Confidentiality Rules, 42 Cfr 74.53(b) (c), 405.1316(f)(2)(3) And 441.16(a)(b) And (c)

IC 113927 under ICR 198804-0938-007 · OMB 0938-0527.

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Information Collection (IC) Details

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IC Title:	MEDICARE, MEDICAID, AND CLINICAL LABORATORIES IMPROVEMENT ACT (CLIA) PATIENT CONFIDENTIALITY RULES, 42 CFR 74.53(B) (C), 405.1316(F)(2)(3) AND 441.16(A)(B) AND (C)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFR-R-110				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,500	4,500
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.