Information Collection Requirements Referenced in HIPAA for the Group Market -- Supporting Regulations 45 CFR 146 and Forms/Instructions

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0702 can be found here:

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Information Collection (IC) Details

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IC Title:	Information Collection Requirements Referenced in HIPAA for the Group Market -- Supporting Regulations 45 CFR 146 and Forms/Instructions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

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-206				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,030	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	43,000,000	3,831	-272,231	43,268,400
Annual IC Time Burden (Hours)	2,700,000	45,675	-3,245,675	5,900,000
Annual IC Cost Burden (Dollars)	0	0	-30,800,000	30,800,000

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.