Survey of Colorectal Cancer Screening Policies, Programs and Systems in U.S. Health Plans

ICR 200503-0925-002

OMB: 0925-0548

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0925-0548 200503-0925-002
Historical Active
HHS/NIH
Survey of Colorectal Cancer Screening Policies, Programs and Systems in U.S. Health Plans
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 06/24/2005
Retrieve Notice of Action (NOA) 03/16/2005
Approved consistent with NIH memo submitted to OMB 06/20/05 under the following terms: the incentive rate provided to all respondents shall be $50, and prior to fielding NIH will report to OMB on the degree of overlap in the sample frame w/r/t respondents who cover mulitple health plans.
  Inventory as of this Action Requested Previously Approved
06/30/2008 06/30/2008
400 0 0
132 0 0
0 0 0

Nationally representative survey of U.S. health plans, survey respondents will be health plan medical directors. Results with enable NCI to assess the impact of recent colorectal cancer screening requirements and diffusion of best practices.

None
None


No

1
IC Title Form No. Form Name
Survey of Colorectal Cancer Screening Policies, Programs and Systems in U.S. Health Plans

  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 400 0 0 400 0 0
Annual Time Burden (Hours) 132 0 0 132 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
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.
03/16/2005


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