This collection
has been in violation since its expiration in June 2010, a fact
which shall be noted in the next Information Collection
Budget.
Inventory as of this Action
Requested
Previously Approved
02/29/2020
36 Months From Approved
06/30/2010
500
0
500
500
0
500
0
0
0
The purpose of this information
collection request is to reinstate and to update the complaint form
to capture complaint information voluntarily submitted to the
Centers for Medicare and Medicaid Services (CMS), National
Standards Group by the public regarding the Health Insurance
Portability and Accountability Act (HIPAA) Administrative
Simplification (A.S.) regulations with the exception of the Privacy
and Security Rules.
This is a reinstatement with
change of a previously approved information collection request;
however, the burden estimate remains that same at 1 hour per
respondent for a total of 500 hours per year across all
respondents.
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.