Identification of Extension Units of Outpatient Physical Therapy/Outpatient Speech Pathology Providers and Support Regs. (CMS-381)

ICR 201106-0938-019

OMB: 0938-0273

Federal Form Document

ICR Details
0938-0273 201106-0938-019
Historical Active 200809-0938-003
HHS/CMS
Identification of Extension Units of Outpatient Physical Therapy/Outpatient Speech Pathology Providers and Support Regs. (CMS-381)
Extension without change of a currently approved collection   No
Regular
Approved without change 08/11/2011
Retrieve Notice of Action (NOA) 06/21/2011
  Inventory as of this Action Requested Previously Approved
08/31/2014 36 Months From Approved 12/31/2011
2,960 0 2,960
740 0 740
0 0 0

Medicare provides OPT/OSP providers to be surveyed to determine compliance with Federal Regulations. All locations where OPT/OSP providers furnish services must meet these requirements. The CMS-381 is the form used to identify all the OPT/OSP locations.

None
None

Not associated with rulemaking

  76 FR 18222 04/01/2011
76 FR 34075 06/10/2011
No

  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 2,960 2,960 0 0 0 0
Annual Time Burden (Hours) 740 740 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$474
No
No
No
No
No
Uncollected
Mitch Bryman 410 786-5258 [email protected]

  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.
06/21/2011


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