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Sec. 1867 Of The Social Security Act: Examination & Treatmt. For Emergency Medical Conditions & Women In Active Labor & 42 Cfr 489.24 Essentials Of Provider Agreements, Etc.

IC 113917 under ICR 198904-0938-007 · OMB 0938-0522.

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IC Title:

SEC. 1867 OF THE SOCIAL SECURITY ACT: EXAMINATION & TREATMT. FOR EMERGENCY MEDICAL CONDITIONS & WOMEN IN ACTIVE LABOR & 42 CFR 489.24 ESSENTIALS OF PROVIDER AGREEMENTS, ETC.

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

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Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-595				No	No

Federal Enterprise Architecture Business Reference Module

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

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