EVALUATION OF SOCIAL/HEALTH MAINTENANCE ORGANIZATION (S/HMO) DEMONSTRATION

ICR 198811-0938-004

OMB: 0938-0450

Federal Form Document

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Document
Name
Status
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IC Document Collections
ICR Details
0938-0450 198811-0938-004
Historical Active 198508-0938-012
HHS/CMS
EVALUATION OF SOCIAL/HEALTH MAINTENANCE ORGANIZATION (S/HMO) DEMONSTRATION
Revision of a currently approved collection   No
Regular
Approved without change 02/01/1989
Retrieve Notice of Action (NOA) 11/02/1988
  Inventory as of this Action Requested Previously Approved
02/28/1992 02/28/1992 11/30/1988
2,991 0 3,000
2,991 0 2,991
0 0 0

THE S/HMO DEMONSTRATION AND EVALUATION HAS BEEN CONGRESSIONALLY MANDATED. THE PROPOSED PRIMARY DATA COLLECTION WILL PERMIT HCFA TO MEASURE THE EFFECTS OF THE S/HMO ON MEDICARE BENEFICIARIES' HEALTH STATUS, BENEFICIARIES' SATISFACTION WITH THE S/HMO ALTERNATIVE, AND S/HMO MARKETING EFFECTIVENESS. THE S/HMO AS AN EVOLVING ORGANIZATION WILL ALSO BE STUDIED.

None
None


No

1
IC Title Form No. Form Name
EVALUATION OF SOCIAL/HEALTH MAINTENANCE ORGANIZATION (S/HMO) DEMONSTRATION HCFA-506

  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 2,991 3,000 0 -9 0 0
Annual Time Burden (Hours) 2,991 2,991 0 0 0 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.
11/02/1988


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