PHYSICIAN PAYMENT DIFFERENTIALS IN GROUP PRACTICES SURVEY

ICR 199203-0938-002

OMB: 0938-0605

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
0938-0605 199203-0938-002
Historical Active
HHS/CMS
PHYSICIAN PAYMENT DIFFERENTIALS IN GROUP PRACTICES SURVEY
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 04/17/1992
Retrieve Notice of Action (NOA) 03/19/1992
  Inventory as of this Action Requested Previously Approved
04/30/1993 04/30/1993
135 0 0
420 0 0
0 0 0

A SURVEY WILL IDENTIFY AND DESCRIBE INNOVATIVE PHYSICIAN PAYMENT MECHANISMS IN PHYSICIAN GROUP PRACTICES. CRITERIA USED BY PHYSICIANS CAN BE USED BY HCFA IN MAKING POLICY DECISION ON PHYSICIAN PAYMENT REFORM.

None
None


No

1
IC Title Form No. Form Name
PHYSICIAN PAYMENT DIFFERENTIALS IN GROUP PRACTICES SURVEY HCFA-R-23

  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 135 0 0 135 0 0
Annual Time Burden (Hours) 420 0 0 420 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.
03/19/1992


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