State Medicaid Fraud Control Units Annual Report and Recertification Application

ICR 200708-0990-001

OMB: 0990-0162

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2007-08-08
ICR Details
0990-0162 200708-0990-001
Historical Active 200401-0990-001
HHS/HHSDM
State Medicaid Fraud Control Units Annual Report and Recertification Application
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 10/12/2007
Retrieve Notice of Action (NOA) 08/15/2007
  Inventory as of this Action Requested Previously Approved
10/31/2010 36 Months From Approved
98 0 0
4,557 0 0
0 0 0

The information contained in the annual reports and recertification application requests is required for the yearly certification/recertification of the current 49 state Medicaid Fraud Control Units by the Office of Inspector General (OIG). The information collected is reviewed and evaluated by the OIG to insure that federal matching grant funds to the Units are only expended for allowable costs incurred by the Units. The OIG also uses the information to determine if a particular state unit or units' needs technical assistance.

PL: Pub.L. 95 - 142 17 Name of Law: null
  
None

Not associated with rulemaking

  72 FR 18657 04/13/2007
72 FR 35710 06/29/2007
No

2
IC Title Form No. Form Name
Certification/Recertification Application
State Medicaid Fraud Control Units Annual Report and Recertification Application

  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 98 0 0 50 48 0
Annual Time Burden (Hours) 4,557 0 0 1,813 2,744 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is reinstatement with change

$5,292
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Saleda Perryman

  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.
08/09/2007


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