INFORMATION COLLECTION REQUIREMENTS CONCERNING SYSTEMS PERFORMANCE REVIEW (SPR)

ICR 198909-0938-007

OMB: 0938-0487

Federal Form Document

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Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
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ICR Details
0938-0487 198909-0938-007
Historical Active 198801-0938-007
HHS/CMS
INFORMATION COLLECTION REQUIREMENTS CONCERNING SYSTEMS PERFORMANCE REVIEW (SPR)
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 12/07/1989
Retrieve Notice of Action (NOA) 09/06/1989
This information collection is approved through January, 1991. As a condition of approval, HCFA will consider the attached remarks made by the State of New York, and respond to them before submission of the next clearance package to OMB.
  Inventory as of this Action Requested Previously Approved
01/31/1991 01/31/1991
22 0 0
44,000 0 0
0 0 0

THE PURPOSE OF THE SPR WHICH EVALUATES THE MEDICAID MANAGEMENT INFORMATION SYSTEMS IS TO IMPROVE THE EFFECTIVENESS AND EFFICIENCY OF THE MEDICAID PROGRAM ON AN INDIVIDUAL STATE BASIS AND FOR THE PROGRAM OVERALL.

None
None


No

1
IC Title Form No. Form Name
INFORMATION COLLECTION REQUIREMENTS CONCERNING SYSTEMS PERFORMANCE REVIEW (SPR) HCFA-R-86

  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 22 0 0 0 22 0
Annual Time Burden (Hours) 44,000 0 0 0 44,000 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.
09/06/1989


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