Children's Hospital Graduate Medical Eduction Program

Forms and Documents

Document Name	Status
Form 1-2 Children's Hospital Graduate Medical Eduction Payment Program Form and Instruction	Modified
CHGME_OMB_Cover_Memo_ACA_Changes_3-18-11.docx Supplementary Document	2011-03-22
FY2010 OMB CHGME Guidance and Applications.pdf Supplementary Document	2011-03-22
OMB_Supporting_Statement update-5-25-11.docx Supporting Statement A	2011-06-10

IC Document Collections

IC ID	Document Title	Status
6495	Children's Hospital Graduate Medical Eduction Payment Program Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0247	ICR Reference No: 201103-0915-001
Status: Historical Active	Previous ICR Reference No: 201002-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Children's Hospital Graduate Medical Eduction Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/27/2011
	Date Received in OIRA: 03/22/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2014	36 Months From Approved	06/30/2013
Responses	60	0	60
Time Burden (Hours)	3,730	0	3,500
Cost Burden (Dollars)	0	0	0

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Abstract: The Healthcare Research and Quality Act of 1999 amended the Public Health Service Act to establish a new program to support graduate medical education in children's hospitals. Children's hospitals will be requested to submit information reporting the number of full-time equivalent residents applying for training programs. This will determine the amount of direct and indirect expense payments.

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Authorizing Statute(s): PL: Pub.L. 106 - 310 2001 Name of Law: Graduate Medical Education Programs in Children's Hospitals
   PL: Pub.L. 106 - 129 4 Name of Law: Healthcare Research and Quality Act of 1999
   PL: Pub.L. 108 - 490 2 Name of Law: Children's Hospital GME Support Reauthorization Act of 2006
   PL: Pub.L. 106 - 310 2001 Name of Law: Children's Health Act of 2000
   PL: Pub.L. 111 - 148 5503, 5504 Name of Law: Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 5503, 5504 Name of Law: Patient Protection and Affordable Care Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 2697	01/14/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 14032	03/15/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Children's Hospital Graduate Medical Eduction Payment Program	HRSA_CHGME_99, HRSA_CHGME_99-3, HRSA_CHGME_99-5, 1-2, 4	HRSA_CHGME_99-1-2 ,   HRSA_CHGME_99-4 ,   HRSA_CHGME_99 ,   HRSA_CHGME_99-3 ,   HRSA_CHGME_99-5

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ICR Summary 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	60	60	0	0	0	0
Annual Time Burden (Hours)	3,730	3,500	230	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Centers for Medicare and Medicaid Services' final rule regarding Sections 5503, 5504, 5505 and 5506 of the Affordable Care Act of 2010 (Vol. 75, No. 226, 11/24/2010) requires some modification of the data collection within the CHGME Payment Program Application. In the previous ICR, there was an estimated total of 3499.8 burden hours. With the current package, we are requesting a total of 3729.6 hours, which is an increase of 229.8 burden hours.

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Annual Cost to Federal Government: $8,489

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 03/22/2011

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