Hospitals and Health Care Complex Cost Report and Supporting Regulation in 42 CFR 413.20 and 413.24

ICR 201008-0938-007

OMB: 0938-0050

Federal Form Document

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2010-08-12
IC Document Collections
ICR Details
0938-0050 201008-0938-007
Historical Active 201005-0938-007
HHS/CMS
Hospitals and Health Care Complex Cost Report and Supporting Regulation in 42 CFR 413.20 and 413.24
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 08/13/2010
Retrieve Notice of Action (NOA) 08/13/2010
  Inventory as of this Action Requested Previously Approved
08/31/2013 08/31/2013 08/31/2013
6,174 0 6,174
4,155,102 0 4,155,102
0 0 0

Form CMS 2552-10 is used by hospitals participating in the Medicare program to report the health care costs to determine the amount of reimbursable costs for services rendered to Medicare beneficiaries.

Statute at Large: 18 Stat. 1815 Name of Statute: null
   Statute at Large: 18 Stat. 1861 Name of Statute: null
  
None

Not associated with rulemaking

Yes

1
IC Title Form No. Form Name
Hospitals and Health Care Complex Cost Report (CMS-2552-10)

  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 6,174 6,174 0 0 0 0
Annual Time Burden (Hours) 4,155,102 4,155,102 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$95,042,000
No
No
No
Uncollected
No
Uncollected
Bonnie Harkless 4107865666

  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.
08/13/2010


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