Information Collection Request

Healthcare Fraud Prevention Partnership (HFPP): Data Sharing and Information Exchange

ICR 201401-0938-013 · OMB 0938-1251 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10501 Generalized Claims Data Call Submission Form New Available
Supporting Statement Part B.docx Supporting Statement B Uploaded 2014-01-17 Available
HFPP 60_day PRA comment and response.pdf Supplementary Document Uploaded 2014-01-17 Available
CMS-10501_Supporting_Statement_Part_A.docx Supporting Statement A Uploaded 2014-01-17 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
226677 Generalized Claims Data Call Submission Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2017 36 Months From Approved
75 0 0
180,000 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Generalized Claims Data Call Submission CMS-10501 Data Submission Template

table that charts list 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 75 0 75 0 0 0
Annual Time Burden (Hours) 180,000 0 180,000 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No