Information Collection Requirements for Sole Community HHAs at 42 CFR Part 424.22(d)(2), (f), and (g)

ICR 199602-0938-007

OMB: 0938-0489

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0489 199602-0938-007
Historical Active 199207-0938-004
HHS/CMS
Information Collection Requirements for Sole Community HHAs at 42 CFR Part 424.22(d)(2), (f), and (g)
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 04/15/1996
Retrieve Notice of Action (NOA) 02/15/1996
  Inventory as of this Action Requested Previously Approved
04/30/1999 04/30/1999
20 0 0
40 0 0
0 0 0

These regulations implement the rules for participation of HHAs in Medicare and the establishment and review of plans of care for home health services. These regulations make it easier for certain HHAs to meet certification and plan of care requirements.

None
None


No

1
IC Title Form No. Form Name
Information Collection Requirements for Sole Community HHAs at 42 CFR Part 424.22(d)(2), (f), and (g) HCFA-R-85

  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 20 0 0 20 0 0
Annual Time Burden (Hours) 40 0 0 40 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.
02/15/1996


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