DATA 2000 Waiver Training Payment Program Application for Payment

Forms and Documents

Document Name	Status
Form 1 DATA 2000 Waiver Training Payment Program Application for Payment Form and Instruction	New
FINALPRA_SUPPORT_Supporting Statement A.docx Supporting Statement A	2020-12-29

IC Document Collections

IC ID	Document Title	Status
244948	DATA 2000 Waiver Training Payment Program Application for Payment Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202012-0906-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: DATA 2000 Waiver Training Payment Program Application for Payment
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/29/2020

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	2,416	0
Time Burden (Hours)	1,208	0
Cost Burden (Dollars)	0	0

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Abstract: This form allows Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to apply for payments based on the average cost of training to obtain DATA 2000 waivers for their physicians and practitioners to furnish opioid use disorder treatment services. The form also provides HRSA with the requisite data to validate qualifying DATA 2000 waiver possessions for the purpose of ensuring accurate payments to FQHCs and RHCs.

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Authorizing Statute(s): PL: Pub.L. 115 - 271 6083 Name of Law: Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients
   US Code: 42 USC 1395m Name of Law: Special payment rules for particular items and services;
   US Code: 42 USC 1395I Name of Law: Payment of benefits
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 63121	10/06/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 85648	12/29/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
DATA 2000 Waiver Training Payment Program Application for Payment	1	SUPPORT Act_Application_final.docx

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ICR Summary of Burden

	Total Request	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	2,416	0	0	2,416	0	0
Annual Time Burden (Hours)	1,208	0	0	1,208	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new ICR so burden increases from zero (0).

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Annual Cost to Federal Government: $102,662

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/29/2020

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