Information Collection Request

(CMS-R-65) Final Peer Review Organizations Sanction and Supporting Regulations

ICR 201705-0938-007 · OMB 0938-0444 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-R-65 Information Collection Requirements in Final Peer Review Organizations Sanction Regulations 42 CFR Sections 1004.40, 1004.50, 1004.50, 1004.60, 1004.70 Form and Instruction Modified Available
CMS-R-65 Final Supporting Statement -2-12-18.docx Supporting Statement A Uploaded 2018-02-12 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8053 Information Collection Requirements in Final Peer Review Organizations Sanction Regulations 42 CFR Sections 1004.40, 1004.50, 1004.50, 1004.60, 1004.70 Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2021 36 Months From Approved
18 0 0
4,716 0 0
0 0 0





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IC Title Form No. Form Name
Information Collection Requirements in Final Peer Review Organizations Sanction Regulations 42 CFR Sections 1004.40, 1004.50, 1004.50, 1004.60, 1004.70 CMS-R-65 Sanctions Template Letter

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 18 0 0 0 -35 53
Annual Time Burden (Hours) 4,716 0 0 0 -9,170 13,886
Annual Cost Burden (Dollars) 0 0 0 0 0 0


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