Information Collection Requirements Referenced in HIPAA for the Individual Market and Supporting Regulations -- 45 CFR 148.120, 122, 124, 128

ICR 199712-0938-003

OMB: 0938-0703

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0703 199712-0938-003
Historical Active 199704-0938-003
HHS/CMS
Information Collection Requirements Referenced in HIPAA for the Individual Market and Supporting Regulations -- 45 CFR 148.120, 122, 124, 128
Extension without change of a currently approved collection   No
Emergency 12/31/1997
Approved without change 12/31/1997
Retrieve Notice of Action (NOA) 12/23/1997
This emergency submission is approved for use through 6/98 under the condition that the next submission for OMB review responds to OMB's previous comments dated May 30, 1997 and allows for full public comment pursuant to the regular PRA procedures.
  Inventory as of this Action Requested Previously Approved
06/30/1998 06/30/1998 12/31/1997
3,600,000 0 3,600,000
900,000 0 900,000
0 0 0

Information collection requirements will ensure that issuers in the individual market will provide individuals with documentation necessary to demonstrate prior credible coverage and ensure States with the flexibility to implement State alternative mechanisms to protect HIPAA eligible individuals.

None
None


No

  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 3,600,000 3,600,000 0 0 0 0
Annual Time Burden (Hours) 900,000 900,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
12/23/1997


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