Information Collection

Access Monitoring Procedures Following Rate Reduction SPA (sec. 447.203(b)(6)(ii))

IC 197689 under ICR 202601-0938-011 · OMB 0938-1134.

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Information Collection (IC) Details

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IC Title:	Access Monitoring Procedures Following Rate Reduction SPA (sec. 447.203(b)(6)(ii))	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 447.203(b)(6)(ii)

Information Collection 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: 12	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	804	804
Annual IC Cost Burden (Dollars)	0	0

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