Information Collection

Information Collection Requirements in Final Peer Review Organization Sanction Regulations -- 42 CFR Sections 1004.40, 1004.50, 1004.60, and 1004.70

IC 8051 under ICR 199905-0938-012 · OMB 0938-0444.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0444 can be found here:

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Information Collection (IC) Details

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IC Title:	Information Collection Requirements in Final Peer Review Organization Sanction Regulations -- 42 CFR Sections 1004.40, 1004.50, 1004.60, and 1004.70	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

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-65				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,060	1,060
Annual IC Time Burden (Hours)	22,684	22,684
Annual IC Cost Burden (Dollars)	0	0

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Title	Document	Date Uploaded

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