Physicians' Referrals to Health Care Entitles With Which They Have Financial Relationships and Supporting Regulations in 42 CFR, Sections 411.352 through 411.361

ICR 200407-0938-006

OMB: 0938-0846

Federal Form Document

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Document
Name
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ICR Details
0938-0846 200407-0938-006
Historical Active 200107-0938-016
HHS/CMS
Physicians' Referrals to Health Care Entitles With Which They Have Financial Relationships and Supporting Regulations in 42 CFR, Sections 411.352 through 411.361
Revision of a currently approved collection   No
Regular
Approved with change 11/05/2004
Retrieve Notice of Action (NOA) 07/23/2004
  Inventory as of this Action Requested Previously Approved
11/30/2007 11/30/2007 11/30/2004
62,824 0 1
422,008 0 1
0 0 0

The final rule (HCFA-1809) incorporated into regulations the provisions in paragraphs (a), (b), (c), (d), and (h) of section 1877 of the Social Security Act. Under section 1877, if a physician or a member of a physician or a member of a physician's immediate family has a financial relationship with a health care entity, the physiican may not refer Medicare patients to that entity for the furnishing of 11 designated health services, unless an exception applies. In addition, section 1877 prohibits an entity from presenting or causing to be presented a Medicare claim or bill to any individual, third party payer, or other....

None
None


No

  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 62,824 1 0 62,823 0 0
Annual Time Burden (Hours) 422,008 1 0 422,007 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
07/23/2004


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