Systems Performance Review (SPR)

ICR 199706-0938-013

OMB: 0938-0487

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
8111 Migrated
ICR Details
0938-0487 199706-0938-013
Historical Active 199406-0938-002
HHS/CMS
Systems Performance Review (SPR)
Extension without change of a currently approved collection   No
Regular
Approved without change 08/20/1997
Retrieve Notice of Action (NOA) 06/26/1997
  Inventory as of this Action Requested Previously Approved
08/31/2000 08/31/2000 08/31/1997
17 0 22
22,100 0 44,000
0 0 0

The Systems Performance Review (SPR) is a vehicle used to evaluate State Medicaid Management Information Systems (MMIS) to determine whether or not a State system satisfies the functional requirements and statistical levels of output relating to accuracy and timeliness. This review necessitates the documentation or maintenance of specific records.

None
None


No

1
IC Title Form No. Form Name
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 17 22 0 -5 0 0
Annual Time Burden (Hours) 22,100 44,000 0 -21,900 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
06/26/1997


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