Information Collection

Medicare and Medicaid Programs; Reporting OASIS Data as Part of the CoPs for HHAs and Supporting Regulations in 42 CFR 484.11 and 484.20

IC 8487 under ICR 200103-0938-012 · OMB 0938-0761.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0761 can be found here:

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Information Collection (IC) Details

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IC Title:	Medicare and Medicaid Programs; Reporting OASIS Data as Part of the CoPs for HHAs and Supporting Regulations in 42 CFR 484.11 and 484.20	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-209				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,100	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	85,200	77,000	8,200
Annual IC Time Burden (Hours)	862,709	-133,659	996,368
Annual IC Cost Burden (Dollars)	17,800,000	-11,200,000	29,000,000

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