INFORMATION COLLECTION REQUIREMENTS IN BPD-311-F, REVALUATION OF ASSETS

ICR 198910-0938-006

OMB: 0938-0556

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
0938-0556 198910-0938-006
Historical Active
HHS/CMS
INFORMATION COLLECTION REQUIREMENTS IN BPD-311-F, REVALUATION OF ASSETS
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 01/10/1990
Retrieve Notice of Action (NOA) 10/20/1989
  Inventory as of this Action Requested Previously Approved
01/31/1993 01/31/1993
102 0 0
26 0 0
0 0 0

SECTION 1902(A)(13)(B) AND 1902(A(13)(C) REQUIRE STATE MEDICAID AGENCI TO PROVIDE SATISFACTORY ASSURANCES THAT THE METHODS AND STANDARDS FOR DETERMINING PAYMENT RATES FOR HOSPITALS AND LONG-TERM CARE FACILITIES WILL RESULT IN PAYMENT RATES WHICH ARE INCREASED, SOLELY AS A RESULT O A CHANGE IN OWNERSHIP BY NO MORE THAN THE STATUTORY LIMIT. THE STATE MEDICAID AGENCY IS REQUIRED TO PROVIDE THIS ASSURANCE WHENEVER IT

None
None


No

1
IC Title Form No. Form Name
INFORMATION COLLECTION REQUIREMENTS IN BPD-311-F, REVALUATION OF ASSETS HCFA-R-130

  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 102 0 0 102 0 0
Annual Time Burden (Hours) 26 0 0 26 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
10/20/1989


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