Analysis of Malpractice Premium Data

ICR 200306-0938-003

OMB: 0938-0575

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
8178 Migrated
ICR Details
0938-0575 200306-0938-003
Historical Active 200003-0938-003
HHS/CMS
Analysis of Malpractice Premium Data
Extension without change of a currently approved collection   No
Regular
Approved without change 08/13/2003
Retrieve Notice of Action (NOA) 06/04/2003
  Inventory as of this Action Requested Previously Approved
08/31/2006 08/31/2006 08/31/2003
50 0 50
150 0 150
0 0 0

Survey of medical liability insurers for use in computing the malpractice component of the geographic practice cost index as set forth in the Omnibus Budget Reconciliation Act of 1989, H.R. 3299.

None
None


No

1
IC Title Form No. Form Name
Analysis of Malpractice Premium Data CMS-R-143

  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 50 50 0 0 0 0
Annual Time Burden (Hours) 150 150 0 0 0 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.
06/04/2003


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