OMB control number
OMHA Annual Appellant Climate Survey
OMB 0990-0330 ยท HHS/HHSDM.
OMB 0990-0330
The Office of Medicare Hearings and Appeals (OMHA)requests a three year programmatic clearance from the OMB to conduct customer research through external surveys by means of telephone interviews and web-based suveys. The proposed information collection request covers all types of OMHA appellants, with a primary focus on the three appellant types who receive benefits from OMHA-beneficiares, providers, and suppliers.
The latest form for OMHA Annual Appellant Climate Survey expires 2027-08-31 and is listed under ICR 202403-0990-005.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form Appendix B1 Health Care Providers and Suppliers | Form and Instruction |
| Appellant Climate Survey OMB Part A - Final.docx | Supporting Statement A |
 60-day FRN 0990-0330.pdf | Supplementary Document |
| Appellant Climate Survey OMB Part B - Revised4 Final.docx | Supporting Statement B |
 Beneficiaries |
Other-Introductory Letter English |
| Health Care Providers and Suppliers |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202403-0990-005 | Revision of a currently approved collection | 2024-04-19 | Approved with change | |
| 202103-0990-004 | Revision of a currently approved collection | 2021-05-26 | Approved with change | |
| 201709-0990-001 | Revision of a currently approved collection | 2018-01-30 | Approved with change | |
| 201411-0990-001 | Extension without change of a currently approved collection | 2014-11-26 | Approved without change | |
| 201110-0990-001 | Reinstatement with change of a previously approved collection | 2011-10-17 | Approved without change | |
| 201109-0990-004 | Revision of a currently approved collection | 2011-09-30 | Improperly submitted and continue | |
| 200804-0990-003 | New collection (Request for a new OMB Control Number) | 2008-04-24 | Approved without change |
OMB Details
Health Care Providers and Suppliers
Federal Enterprise Architecture: General Government - Executive Functions
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form Appendix B2 | Appellant Climate Survey Telephone Spanish | Fillable Fileable | Form and instruction |
| Form Appendix B1 | Appellant Climate Survey Telephone English | Fillable Fileable | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.