Medicare Geographic Classification Review Board Procedures and Criteria and Supporting Regulations in 42 CFR, Section 412.256

ICR 201710-0938-001

OMB: 0938-0573

Federal Form Document

ICR Details
0938-0573 201710-0938-001
Active 201612-0938-023
HHS/CMS CMS-R-138
Medicare Geographic Classification Review Board Procedures and Criteria and Supporting Regulations in 42 CFR, Section 412.256
Extension without change of a currently approved collection   No
Regular
Approved without change 01/03/2018
Retrieve Notice of Action (NOA) 10/04/2017
Before this ICR is renewed, CMS should ensure that each IC and/or form includes the OMB Control Number, estimated time to complete the form, and expiration date.
  Inventory as of this Action Requested Previously Approved
01/31/2021 36 Months From Approved 06/30/2018
300 0 300
300 0 300
0 0 0

Section 1886(d)(10) of the Social Security Act established the Medicare Geographic Classification Review Board (MGCRB), an entity with the authority to accept short-term hospital inpatient prospective payment system applications from hospitals requesting geographic reclassification for wage index or standardized amount payment purposes and issue decisions on these requests. This regulation sets up the application process for prospective payment system hospitals that choose to appeal their geographic status to the MGCRB.

Statute at Large: 18 Stat. 1886 Name of Statute: null
  
None

Not associated with rulemaking

  82 FR 31331 07/06/2017
82 FR 43378 09/15/2017
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 300 300 0 0 0 0
Annual Time Burden (Hours) 300 300 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$19,200
No
    No
    No
No
No
No
Uncollected
Kayla Williams 410 786-5887 [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.
10/04/2017


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