VOLUNTARY "PARTNER/REGULATED ENTITY" CUSTOMER SURVEYS TO IMPLEMENT EXECUTIVE ORDER 12862 WITHIN HCFA

ICR 199409-0938-001

OMB: 0938-0660

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0660 199409-0938-001
Historical Active
HHS/CMS
VOLUNTARY "PARTNER/REGULATED ENTITY" CUSTOMER SURVEYS TO IMPLEMENT EXECUTIVE ORDER 12862 WITHIN HCFA
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/01/1994
Retrieve Notice of Action (NOA) 09/02/1994
This HCFA generic clearance request for "partners" and "regulated" entities (and the enclosed revisions to the Supporting Statement) are approved for use through 11/97 under the following conditions: 1) HCFA provides OMB with copies of the proposed surveys ten days before dissemination; and 2) HCFA incorporates the attached guidance "Consideration for Information Collections of Customer Satisfaction by Regulators of Regulated Entities" in conducting surveys of "regulate entities" or "partners." HCFA should also provide a written explanation of how the beneficiary satisfaction surveys will yield unique information that the Current Beneficiary survey does not. When information from both surveys is available, OMB would like a briefing on the extent to which the findings are interrelated.
  Inventory as of this Action Requested Previously Approved
11/30/1997 11/30/1997
138,936 0 0
26,222 0 0
0 0 0

THESE VOLUNTARY CUSTOMER SURVEYS WILL BE USED TO IMPLEMENT E.O. 12862 ASCERTAIN CUSTOMER SATISFACTION WITH HCFA/REGULATED ENTITIES PROGRAMS TERMS OF SERVICE QUALITY. SURVEYS WILL INVOLVE INDIVIDUALS THAT ARE DIRECT OR INDIRECT BENEFICIARIES OF HCFA/REGULATED ENTITIES SERVICE AND/OR ASSISTANCE.

None
None


No

1
IC Title Form No. Form Name
VOLUNTARY "PARTNER/REGULATED ENTITY" CUSTOMER SURVEYS TO IMPLEMENT EXECUTIVE ORDER 12862 WITHIN HCFA

  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 138,936 0 0 138,936 0 0
Annual Time Burden (Hours) 26,222 0 0 26,222 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.
09/02/1994


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