Information Collection Request

Health Integrity and Protection Data Bank for Final Adverse Information on Health Care Providers, Suppliers and Practitioners

ICR 200708-0915-001 · OMB 0915-0239 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form hipdb Health Integrity and Protection Data Bank for Final Adverse Information on Health Care Providers, Suppliers and Practitioners Form and Instruction Modified Available
0239 HIPDB Letter.pdf Supplementary Document Uploaded 2007-07-20 Available
ss 0239 2007.doc Supporting Statement A Uploaded 2007-07-20 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
6485 Health Integrity and Protection Data Bank for Final Adverse Information on Health Care Providers, Suppliers and Practitioners Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2010 36 Months From Approved 10/31/2007
985,754 0 946,515
120,982 0 116,146
3,865,278 0 4,074,000





Reginfo record details
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table that charts list of burden
IC Title Form No. Form Name
Health Integrity and Protection Data Bank for Final Adverse Information on Health Care Providers, Suppliers and Practitioners hipdb hipdb

table that charts list of burden
  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 985,754 946,515 0 0 39,239 0
Annual Time Burden (Hours) 120,982 116,146 0 0 4,836 0
Annual Cost Burden (Dollars) 3,865,278 4,074,000 0 0 -208,722 0


Reginfo record details
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