REFUNDING OF FEDERAL SHARE OF OVERPAYMENTS MADE TO MEDICAID PROVIDERS

ICR 198906-0938-016

OMB: 0938-0535

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
0938-0535 198906-0938-016
Historical Active 198904-0938-043
HHS/CMS
REFUNDING OF FEDERAL SHARE OF OVERPAYMENTS MADE TO MEDICAID PROVIDERS
No material or nonsubstantive change to a currently approved collection   No
Emergency 06/16/1989
Approved with change 06/16/1989
Retrieve Notice of Action (NOA) 06/16/1989
  Inventory as of this Action Requested Previously Approved
03/31/1992 03/31/1992 03/31/1992
2,600 0 2,600
148,200 0 148,200
0 0 0

OVERPAYMENTS ARE OCCASIONALLY MADE TO MEDICAID PROVIDERS BY STATE MEDICAID AGENCIES. STATES MUST REFUND THE FEDERAL SHARE OF OVERPAYMENTS TO HCFA AFTER A 60-DAY RECOVERY PERIOD. DOCUMENTATION ON OUT-OF-BUSINESS OR BANKRUPT PROVIDERS AND THE AGING O OVERPAYMENTS DURING THE RECOVERY PERIOD ARE INCREMENTAL BURDENS REQUIRED BY THIS REGULATION.

None
None


No

1
IC Title Form No. Form Name
REFUNDING OF FEDERAL SHARE OF OVERPAYMENTS MADE TO MEDICAID PROVIDERS HCFA-R-104

  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 2,600 2,600 0 0 0 0
Annual Time Burden (Hours) 148,200 148,200 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.
06/16/1989


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