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Medical Malpractice Payment
National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners: 45 CFR Part 60 Regulations and Forms
OMB: 0906-0081
IC ID: 206481
OMB.report
HHS/HRSA
OMB 0906-0081
ICR 202401-0906-003
IC 206481
( )
Documents and Forms
Document Name
Document Type
Form 2
Medical Malpractice Payment
Form and Instruction
2 Medical Malpractice Payment.pdf
Medical Malpractice Payment.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Medical Malpractice Payment
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
2
Medical Malpractice Payment.pdf
Medical Malpractice Payment.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
System of Record Notice 09-15-0054
FR Citation:
88 FR 17854
Number of Respondents:
11,527
Number of Respondents for Small Entity:
1,045
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
11,527
0
-250
0
0
11,777
Annual IC Time Burden (Hours)
8,311
0
-301
0
0
8,612
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.