Information Collection

Managed Care Adjusted Community Rate (ACR) Proposal and Supporting Regulations in 42 CFR Sections 422.300-422.312

IC 8430 under ICR 199902-0938-010 · OMB 0938-0742.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0742 can be found here:

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Information Collection (IC) Details

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IC Title:	Managed Care Adjusted Community Rate (ACR) Proposal and Supporting Regulations in 42 CFR Sections 422.300-422.312	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-R-228				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	500	100	400
Annual IC Time Burden (Hours)	50,000	10,000	40,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.