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Notice of Research Exception under the Genetic Information Nondiscrimination Act (GINA)
Notice of Research Exception under the Genetic Information Nondiscrimination Act (CMS-10286)
OMB: 0938-1077
IC ID: 191067
OMB.report
HHS/CMS
OMB 0938-1077
ICR 201607-0938-005
IC 191067
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1077 can be found here:
2022-05-10 - Extension without change of a currently approved collection
2019-03-18 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form CMS-10286
Notice of Research Exception under the Genetic Information Nondiscrimination Act (GINA)
Form and Instruction
CMS-10286 GINA Research Execption Notice
CMS-10286 GINA_Research_Exception_Notice rev..doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Notice of Research Exception under the Genetic Information Nondiscrimination Act (GINA)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
45 CFR 148.180(e)(5)(iv)
45 CFR 146.122(c)(5)(iv)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
CMS-10286
GINA Research Execption Notice
CMS-10286 GINA_Research_Exception_Notice rev..doc
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
2
0
0
0
0
2
Annual IC Time Burden (Hours)
1
0
0
0
0
1
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.