Information Collection Requirements in 42 CFR 478.18, 478.34, 478.36, and 478.42, QIO Reconsiderations and Appeals

ICR 200303-0938-011

OMB: 0938-0443

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0443 200303-0938-011
Historical Active 199911-0938-001
HHS/CMS
Information Collection Requirements in 42 CFR 478.18, 478.34, 478.36, and 478.42, QIO Reconsiderations and Appeals
Extension without change of a currently approved collection   No
Regular
Approved with change 08/28/2003
Retrieve Notice of Action (NOA) 03/25/2003
The Agency and OMB have agreed on a wage rate of $15.74 in item 14 of the Supporting Statement dealing with the Federal Cost Burden. Though the derivation of this number was somewhat arbitrary on the part of the Agency, it is reasonable and has been agreed upon as the appropriate wage rate. This collection request is cleared subject to those premises.
  Inventory as of this Action Requested Previously Approved
08/31/2006 08/31/2006 08/31/2003
5,228 0 15,670
2,822 0 3,578
0 0 0

These regulations contain procedures for QIOs (formally known as PROs) to use in reconsideration of initial determinations. The information requirements contained in these regulations are on QIOs to provide information to parties requesting a reconsideration. These parties will use the information as guidelines for appeal rights in instances where issues are still in dispute.

None
None


No

1
IC Title Form No. Form Name
Information Collection Requirements in 42 CFR 478.18, 478.34, 478.36, and 478.42, QIO Reconsiderations and Appeals CMS-R-72

  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 5,228 15,670 0 0 -10,442 0
Annual Time Burden (Hours) 2,822 3,578 0 0 -756 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.
03/25/2003


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