Information Collection

42 CFR 489.20(w)(2) Distribution of Written Notice of Lack of Physician Coverage in Hospital

IC 247550 under ICR 202105-0938-008 · OMB 0938-1034.

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IC Title:

42 CFR 489.20(w)(2) Distribution of Written Notice of Lack of Physician Coverage in Hospital

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 489.20(w)(2)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 210

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,331,817	2,331,817
Annual IC Time Burden (Hours)	38,864	38,864
Annual IC Cost Burden (Dollars)	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.