Information Collection

Home Health CY2011 proposed rule: Face-to-Face encounter, form development (424.22 first year)

IC 193914 under ICR 201007-0938-012 · OMB 0938-1083.

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Information Collection (IC) Details

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IC Title:	Home Health CY2011 proposed rule: Face-to-Face encounter, form development (424.22 first year)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 424.22(a)(1)(v)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9,432	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to New Statute
Annual Number of Responses for this IC	9,432	9,432
Annual IC Time Burden (Hours)	4,716	4,716
Annual IC Cost Burden (Dollars)	0	0

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