INDIRECT COST OF MEDICAL EDUCATION - PROVIDER REIMBURSEMENT MANUAL

ICR 198901-0938-006

OMB: 0938-0457

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0938-0457 198901-0938-006
Historical Active 198510-0938-006
HHS/CMS
INDIRECT COST OF MEDICAL EDUCATION - PROVIDER REIMBURSEMENT MANUAL
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 03/09/1989
Retrieve Notice of Action (NOA) 01/04/1989
This information collection request is returned as improperly submitted because it does not include a burden disclosure statement.
  Inventory as of this Action Requested Previously Approved
03/31/1990 03/31/1990
1,015 0 0
2,030 0 0
0 0 0

HOSPITALS ARE REQUIRED TO SUBMIT AN ANNUAL REPOR ON THE NUMBER OF I&RS FURNISHING SERVICES. THIS REPORT WILL FACILITAT FINAL ADJUSTMENTS TO COST REPORTS. SECTION 2405.3 OF THE PROVIDER REIMBURSEMENT MANUAL DESCRIBES THE NEW SINGLE DAY METHOD OF COUNTING I&RS.

None
None


No

1
IC Title Form No. Form Name
INDIRECT COST OF MEDICAL EDUCATION - PROVIDER REIMBURSEMENT MANUAL HCFA-R-68

  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 1,015 0 0 0 1,015 0
Annual Time Burden (Hours) 2,030 0 0 0 2,030 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.
01/04/1989


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