Centers for Medicare & Medicaid Services

CMS

Federal Forms

Forms
OMB NumberTitle
0938-1399 (CMS-10695) Quality Payment Program/Merit-Based Incentive Payment System (MIPS) Surveys and Feedback Collections
0938-1398 Accrediting Organization use of CMS Online Hospice Basic Training (CMS-10778)
0938-1397 Generic Clearance for the Center for Clinical Standards and Quality IT Product and Support Teams (CMS-10706)
0938-1396 CMS Medicare Part D E-Prescribing Tools in 42 CFR 423.128(d)(1) and 423.160 (CMS-10755)
0938-1395 Medicare Part C and Part D Program Audit and Industry-Wide Part C Timeliness Monitoring Project (TMP) Protocols (CMS-10717)
0938-1394 Pharmacy Benefit Manager Transparency (CMS-10725)
0938-1393 Non-Quantitative Treatment Limitation Analyses and Compliance Under MHPAEA (CMS-10773)
0938-1392 Electronic Medical Documentation Interoperability (EMDI) Pre and Post Pilot Measures Survey (CMS-10714)
0938-1391 CLIA Collection of Information Requirements Related to SARS-CoV-2 Test Results Reporting (CMS-10757)
0938-1390 Administrative Simplification HIPAA Compliance Review (CMS-10662)
0938-1388 Value in Opioid Use Disorder Treatment Demonstration (CMS-10728)
0938-1387 Medicare Coverage of Items and Services for Coverage with Evidence Development (CMS-10697)
0938-1386 Applicable Integrated Plan Coverage Decision Letter (CMS-10716)
0938-1385 Annual State Report on Value Based Purchasing Arrangements (VBP) Supplemental Rebate Agreements (CMS-10722)
0938-1384 Submissions of 1135 Waiver Request Automated Process (CMS-10752)
0938-1383 Program Integrity Portal FWA Reporting Module - Part C Plans (CMS-10724)
0938-1382 Generic Clearance for Improving Customer Experience: OMB Circular A–11, Section 280 Implementation) (CMS-10710)
0938-1381 Collection of Premium Credit Adjustment Data Related to COVID-19 Emergency (CMS-10751)
0938-1380 Proposed Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Process and Requirements for a Potential National Model (CMS-10708)
0938-1379 Medicare Current Beneficiary Survey (MCBS) COVID-19 Rapid Response Supplement (CMS-P-0015A)
0938-1378 Model Medicare Advantage and Medicare Prescription Drug Plan Individual Enrollment Request Form (CMS-10718)
0938-1377 Medicare Enrollment Application for Clinics/Group Practices and Other Suppliers (CMS-855B)
0938-1376 Temporary Extraordinary Circumstances Exception for Excepted Provider-Based Departments (CMS-10730)
0938-1375 Excepted Benefit Health Reimbursement Arrangements
0938-1374 Hospital Survey for Specified Covered Outpatient Drugs (SCODs) (CMS-10709)
0938-1373 Accrediting Organization Change of Ownership Requirements (CMS-10705)
0938-1372 Transparency in Pricing Information (CMS-10715)
0938-1371 Data Request and Attestation for PDP Sponsors (CMS-10691)
0938-1370 Testing of Web Survey Design and Administration for CMS Experience of Care Surveys (CMS-10694)
0938-1369 CY 2020 Proposed Requirements for Hospitals to Make Public a List of Their Standard Charges (CMS-10707)
0938-1368 Proposed Prior Authorization Process and Requirements for Certain Hospital Outpatient Department (OPD) Services (CMS-10711)
0938-1367 Religious Nonmedical Health Care Institutions (RNHCIs) Conditions of Participation and Supporting Regulations (CMS-10712)
0938-1366 Information Collection Requirements Contained in the State Flexibility to Stabilize the Market Grant Program (CMS-10657)
0938-1365 Information Collection Requirement for Mid-Year Formulary Change Reporting and Notice Requirement (CMS-10696)
0938-1364 Home Health (HH) National Provider Survey (CMS-10688)
0938-1363 Reform of Requirements for Long-Term Care Facilities (CMS-10573)
0938-1362 Home and Community Based Services (HCBS) Incident Management Survey (CMS-10692)
0938-1361 Health Reimbursement Arrangements and Other Account-Based Group Health Plans (CMS-10704)
0938-1360 Electronic Visit Verification (EVV) Compliance Survey (CMS-10680)
0938-1359 21st Century Cures Act Section 12002 IMD Study (CMS-10684)
0938-1358 Supporting Statement for Billing and Collection of the Separate Payment for Certain Abortion Services (CMS-10681)
0938-1357 CLIA Proficiency Testing (PT) (CMS-10690)
0938-1356 Evaluation of the CMS Quality Improvement Organizations: Medication Safety and Adverse Drug Event Prevention (CMS-10675)
0938-1355 Medicare Enrollment Application for Physician and Non-Physician Practitioners; (CMS-855i)
0938-1354 Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration (CMS-10673)
0938-1353 Marketplace Operations (CMS-10637)
0938-1352 Quality Measures and Administrative Procedures for the Hospital-Acquired Condition Reduction Program for the FY 2019 IPPS Program Year (CMS-10668)
0938-1351 Limited Wraparound Coverage Reporting (CMS-10571)
0938-1350 CMS Tribal Long Term Services and Supports (LTSS) Program Survey
0938-1349 State Permissions for Enrollment in Qualified Health Plans in the Federally Facilitated Exchange & Non-Exchange Entities (CMS-10650)
0938-1348 QIC Demonstration Evaluation Contractor (QDEC): Analyze Medicare Appeals to Conduct Formal Discussions and Reopenings with DME Suppliers and Part A Providers (CMS-10633)
0938-1347 PRA for the Add-On Payments for New Medical Services and Technologies Policy(CMS-10638)
0938-1346 Triennial Network Adequacy Review for Medicare Advantage Organizations and 1876 Cost Plans (CMS-10636)
0938-1345 Appropriate Use Criteria (AUC) for Diagnostic Imaging Services: Consultation of Specified Applicable AUC through a Qualified Clinical Decision Support Mechanism (CDMS) (CMS-10654)
0938-1344 Coverage of Certain Preventive Services Under the Affordable Care Act (CMS-10653)
0938-1343 Virtual Groups for Merit-Based Incentive Payment System (MIPS) (CMS-10652)
0938-1342 Evaluating Coverage to Care in Communities (CMS-10632)
0938-1341 Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers (CMS-10592)
0938-1340 National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) (CMS-10639)
0938-1339 Evaluating a Pilot Mobile Health Program (CMS-10634)
0938-1338 De Minimis for LIS Individuals and Uniform Exceptions and Appeals Process for Prescription Drug Plans and MA-PD Plans
0938-1337 Changes to Close the Part D Coverage Gap, Improvements to MTM Programs, Independence of LTC Consultant Pharmacists
0938-1336 Agent Broker Training Requirements
0938-1335 Notification of Involuntary Disenrollment by the Centers for Medicare & Medicaid Services for Failure to Pay the Part D Income Related Monthly Adjustment Amount
0938-1334 Credentialing and Privileging Process for Physicians and Practitioners Providing Telemedicine Services
0938-1333 The Medicare Advantage and Prescription Drug Program: Customized Enrollee Data
0938-1332 Montana Health and Economic Livelihood Partnership (HELP) Federal Evaluation (CMS-10635)
0938-1331 Clearance for Evaluation of Stakeholder Training Health Insurance Marketplace and Market Stabilization Programs (CMS-10598)
0938-1330 (CMS-10622) Evaluation of the CMS Quality Improvement Organizations: Reducing Healthcare-Acquired Conditions in Nursing Homes
0938-1329 Information Collection Requirements for Non-Exchange Entities
0938-1328 Initial Request for State Implemented Moratorium Form (CMS-10628)
0938-1327 Programs of All-Inclusive Care for the Elderly (PACE) 2020 Audit Protocol (CMS-10630)
0938-1326 The PACE Organization Application Process in 42 CFR Part 460 (CMS-10631)
0938-1325 (CMS-10578) Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers
0938-1324 Testing Experience and Functional Tools Demonstration: Personal Health Record (PHR) User Survey (CMS-10623)
0938-1323 Medicare Program; Reporting and Returning of Overpayments (CMS-10405)
0938-1322 CMS Healthcare.gov Site Wide Online Survey
0938-1321 Information Collection Requirements for Non-Exchange Entities (CMS-10633)
0938-1320 The Health Insurance Enforcement and Consumer Protections Grant Program (CMS-10605)
0938-1319 Medicaid Program Face-to-Face Requirements for Home Health Services and Supporting Regulations under 42 CFR 440.70(f) and (g) (CMS-10609)
0938-1318 Home Health Face-to-Face Encounter Clinical Templates (CMS-10564)
0938-1317 Reapplication Submission Requirement for Qualified Entities under ACA Section 10332 (CMS-10596)
0938-1316 (CMS-10600) Evaluation of the Medicare Patient Intravenous Immunoglobulin Demonstration
0938-1315 Appropriate Use Criteria (AUC) for Diagnostic Imaging Services: Clinical Decision Support Mechanism (CDSM) Application Process (CMS-10624)
0938-1314 Quality Payment Program/Merit-Based Incentive Payment System (MIPS) (CMS-10621)
0938-1313 Waiver Application for Providers and Suppliers Subject to an Enrollment Moratorium (CMS-10629)
0938-1312 Establishment of an Exchange by a State and Qualified Health Plans (CMS-10593)
0938-1311 Pre-Claim Review Demonstration For Home Health Services (CMS-10599)
0938-1310 Information Collection for Transparency in Coverage Reporting by Qualified Health Plan Issuers (CMS-10572)
0938-1309 QECP Annual Report Workbook Submission Requirement for Qualified Entities under ACA Section 10332 (CMS-10589)
0938-1308 Medicare Outpatient Observation Notice (MOON) (CMS-10611)
0938-1307 (CMS-10587) Medicare and Medicaid Programs: Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies
0938-1306 Temporary Reclassification for Grandfathered LTCH HwHs for Qualification for Temporary Exception from the Site Neutral Payment Rate for Certain Discharges
0938-1305 (CMS-10583) Medicare beneficiaries receiving beta amyloid positron emission tomography (PET) for dementia and neurodegenerative disease
0938-1304 Medicare and Medicaid Program; Program Integrity Enhancements to the Provider Enrollment Process (CMS-10576)
0938-1303 Small Business Health Options Program (SHOP) Effective Date and Termination Notice Requirements (CMS-10555)
0938-1302 Provider Network Coverage Data Collection (CMS-10594)
0938-1301 Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection (CMS-10595)
0938-1300 Healthy Indiana Program (HIP) 2.0 Beneficiary Focus Groups and Informational Interviews (CMS-10615)
0938-1299 (CMS-10539) Medicare and Medicaid Programs: Conditions of Participation for Home Health Agencies (HHA)
0938-1298 Federally Qualified Health Center Cost Report Form (CMS-224-14)
0938-1297 Generic Clearance for the Heath Care Payment Learning and Action Network (CMS-10575)
0938-1296 Initial and Renewal Model of Care Submissions, and Off-cycle Submission of Summaries of Model of Care Changes (CMS-10565)
0938-1295 Essential Community Provider Data Collection to Support QHP Certification for PY 2017 (CMS-10561)
0938-1293 Medicare Program: Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) (CMS-10524)
0938-1292 Coverage of Certain Preventive Services Under the Affordable Care Act (CMS-10459)
0938-1291 (CMS–10551) Nursing Home NationalProvider Survey
0938-1290 (CMS-10550) Hospital National Provider Survey
0938-1289 Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network (CROWNWeb) (CMS-10569)
0938-1288 Appropriate Use Criteria for Advanced Diagnostic Imaging Services (CMS-10570)
0938-1287 Rural Health Clinics (RHCs) Reporting of Healthcare Common Procedure Coding System (HCPCS) and Other Codes as Required for RHC Claims and Supporting Regulations (CMS-10568)
0938-1286 Quality Improvement Strategy Implementation Plan and Progress Report (CMS-10540)
0938-1285 Data Submission for the Federally-facilitated Exchange User Fee Adjustment (CMS-10492)
0938-1284 Information Collection for Machine Readable Data for Provider Network and Prescription Formulary Content for FFM QHPs (CMS-10558)
0938-1283 Risk Corridors Data Validation for the 2014 Benefit Year (CMS-10582)
0938-1282 Children's Health Insurance Program Managed Care and Supporting Regulations (CMS-10554)
0938-1281 State Review of Accreditation Status, Medicaid Managed Care Quality Rating System, and Quality Strategy (QS) and Supporting Regulations in 438.310, 438.330, 438.332, 438.334, and 438.340 (CMS-10553)
0938-1280 Medical Necessity and Contract Amendments Under Mental Health Parity (CMS-10556)
0938-1279 Outcome and Assessment Information Set (OASIS-D) (CMS-10545)
0938-1278 Implementation of Medicare and Medicaid Programs; - Promoting Interoperability Programs Stage 3 (CMS-10552)
0938-1277 Program Integrity:Exchange, Premium Stabilization Programs, and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014; Final Rule II (CMS-10516)
0938-1276 Executive Summary Form for Research Identifiable Data (CMS-10522)
0938-1275 Generic Clearance for Questionnaire Testing and Methodological Research for the Medicare Current Beneficiary Survey (MCBS) (CMS-10549)
0938-1274 (CMS–10531) Transcatheter Mitral Valve Repair (TMVR) National Coverage Decision (NCD)
0938-1273 Emergency Department Patient Experience of Care (EDPEC) Survey Mode Experiments (CMS-10543)
0938-1272 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Mode Experiment (CMS-10542)
0938-1271 Good Cause Processes (CMS-10544)
0938-1270 Ambulatory Surgical Center Quality Reporting Program (CMS-10530)
0938-1269 Hospice Information for Medicare Part D Plans (CMS-10538)
0938-1268 Medicaid Eligibility and Enrollment (EE) Implementation Advanced Planning Document (IAPD) Template (CMS-10536)
0938-1267 Risk Corridors Transitional Policy (CMS-10532)
0938-1266 Cost-Sharing Reduction Reconciliation (CMS-10526)
0938-1265 Quarterly Medicaid and CHIP Budget and Expenditure Reporting for the Medical Assistance Program, Administration and CHIP (MBES/CBES Forms CMS-21 and -21B, -37, and -64) -- (CMS-10529)
0938-1264 Programs of All-Inclusive Care for the Elderly (PACE) PACE Quality Data Monitoring and Reporting (10525)
0938-1263 Medicare Health Care Quality (MHCQ) Demonstration Evaluation: Focus Group and Interview Protocols (CMS-10497)
0938-1262 Program Integrity Portal FWA Reporting Module - Part D Plans (CMS-10517)
0938-1261 Medicare and Medicaid Programs: Conditions of Participation for Community Mental Health Centers and Supporting Regulations in 42 CFR 485
0938-1260 Improving Quality of Care in Medicaid and CHIP through Increased Access to Preventive Services, State Survey (CMS-10521)
0938-1259 Health Care Sharing Ministries Information Collection
0938-1258 Disclosure of State Rating Requirements and Individual Market Special Enrollment Notice (CMS-10454)
0938-1257 National Implementation of the Hospice Experience of Care Survey (CAHPs Hospice Survey - CMS-10537)
0938-1256 Evaluation of the Multi-payer Advanced Primary Care Practice (MAPCP) Demonstration: Provider Survey
0938-1255 (CMS-10519) Physician Quality Reporting System and the Electronic Prescribing Incentive Program Data Assessment, Accuracy and Improper Payments Identification Support
0938-1254 Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)
0938-1253 Evaluation of the Rural Community Hospital Demonstration
0938-1252 Prospective Evaluation of Evidence-Based Community Wellness and Prevention Programs (CMS-10509)
0938-1251 Healthcare Fraud Prevention Partnership (HFPP): Data Sharing and Information Exchange (CMS-10501)
0938-1250 Medicare Coverage of Items and Services in FDA Investigational Device Exemption Clinical Studies--Revision of Medicare Coverage (CMS-10511)
0938-1249 Marketplace Quality Standards (CMS-10520)
0938-1248 Employer Notification Request to HHS of its Objection to Providing Contraceptive Services (CMS-10535)
0938-1247 Generic Social Marketing & Consumer Testing Research (CMS-10437)
0938-1246 Application for Participation in the Intravenous Immune Globulin (IVIG) Demonstration (CMS-10518)
0938-1245 Conditions of Participation for Community Mental Health Centers and Supporting Regulations (CMS-10506)
0938-1244 State-based Marketplace Annual Reporting Tool (SMART) (CMS-10507)
0938-1243 Hospice Quality Reporting Program: Program Evaluation
0938-1242 Long Term Care Hospitals Quality Reporting Program: Program Evaluation
0938-1241 Inpatient Rehabilitation Facilities Quality Reporting Program: Program Evaluation
0938-1240 National Implementation of the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey (CMS-10500)
0938-1239 Nationwide Consumer Assessment of Healthcare Providers and Systems (DCAHPS) Survey for Adults in Medicaid (CMS-10493)
0938-1238 Community First Choice Option Evaluation
0938-1237 Registration, Attestation, Dispute Resolution and Correction, Assumptions Document and Data Retention Requirements for Open Payments (CMS-10495)
0938-1236 CMS Identity Management System (CMS-10452)
0938-1235 Medicare Prior Authorization of Power Mobility Devices (PMDs) Demonstration (CMS-10471)
0938-1234 End Stage Renal Disease (ESRD) System Access Request Form
0938-1233 Medicare Enrollment Application for Registration of Eligible Entities That Provide Health Insurance Coverage Complementary to Medicare Part B and Supporting Regulations
0938-1232 Medical Loss Ratio (MLR) Data Form for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10476)
0938-1231 Annual Report of Physician-Owned Hospital Ownership and/or Investment Interest
0938-1230 Application for Enrollment in Medicare - The Medical Insurance Program (CMS-40B)
0938-1229 Survey on Core Competencies for the Direct Service Workforce (CMS-10512)
0938-1228 The Medicare Advantage and Prescription Drug Program: Part C Explanation of Benefits and Supporting Regulations
0938-1227 Requirements for the Medicare Incentive Reward Program and Provider Enrollment
0938-1226 Physician Quality Reporting System and the Electronic Prescribing Incentive Program
0938-1225 Medicaid Emergency Psychiatric Services Demonstration Evaluation
0938-1224 Evaluation of the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration: Focus Group Protocols
0938-1223 Evaluation of the Multi-Payer Advance Primary Care Practice (MAPCP) Demonstration: Conduct Beneficiary Experience with Care Surveys
0938-1222 Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for the Merit-Based Incentive Payment System (MIPS) (CMS-10450)
0938-1221 Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection (CMS-10488)
0938-1220 Patient Protection and Affordable Care Act; Consumer Assistance Tools and Programs of an Exchange and Certified Application Counselors; Exchange and Insurance Market Standards for 2015
0938-1219 Medicaid Incentives for Prevention of Chronic Diseases Evaluation (CMS-10477)
0938-1218 Basic Health Program Report for Health Insurance Exchange Premium (CMS-10510)
0938-1217 Payment Collections Operations Contingency Plan (CMS-10515)
0938-1216 State Health Insurance Exchange Security Incident Report
0938-1215 Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Exchanges (CMS-10463)
0938-1214 Issuer Reporting Requirements for Selecting a Cost-Sharing Reductions Reconciliation Methodology (CMS-10469)
0938-1213 Program Integrity and Additional State Information Collections
0938-1212 Evaluation of the Graduate Nurse Education Demonstration Program (CMS-10467)
0938-1211 Evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration
0938-1210 Report of a Hospital Dealth Associated with Restraint or Seclusion (CMS-10455)
0938-1209 Emergency Room Patient Experiences with Care Survey
0938-1208 Hospice Experience of Care Survey
0938-1207 Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment
0938-1206 Evaluation of Patient Satisfaction and Experience of Care for Medicare Beneficiaries with ESRD: Impact of the ESRD Prospective Payment System (PPS) and ESRD Quality Incentive Program (QIP)
0938-1205 Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel - CAC (CMS-10494)
0938-1204 Agent/Broker Data Collection in Federally-facilitated Health Insurance Exchanges (CMS-10464)
0938-1203 Consumer Research Supporting Outreach for Health Insurance Marketplace
0938-1202 (CMS-10443) Transcatheter Valve Therapy Registry and KCCQ-10
0938-1201 Medicare Plan Finder Experiment
0938-1200 Evaluation and Development of Outcome Measures for Quality Assessment in Medicare Advantage and Special Needs Plans
0938-1199 MAC Satisfaction Indicator (MSI) Participant Registry
0938-1198 Medicare Enrollment Application for Clinics/ Group Practice and Certain Other Suppliers
0938-1197 Health Insurance Common Claims Form and Supporting Regulations at 42 CFR Part 424, Subpart C (CMS-1500 and CMS-1490S)
0938-1196 Home Health Change of Care Notice (HHCCN) (CMS-10280)
0938-1195 Medicare Advantage Quality Bonus Payment Demonstration
0938-1194 Data Collection to Support Eligibility Determinations and Enrollment for Employees in the Small Business Health Options Program (CMS-10438)
0938-1193 Data Collection to Support Eligibility Determinations and Enrollment for Small Businesses in the Small Business Health Options Program (CMS-10439)
0938-1192 Probable Fraud Measurement Pilot (CMS-10406)
0938-1191 Data Collection to Support Eligibility Determinations for Insurance Affordability Programs and Enrollment through Health Benefits Exchanges, Medicaid and CHIP Agencies (CMS-10440)
0938-1190 Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions (CMS-10466)
0938-1189 Minimum Essential Coverage (CMS-10465)
0938-1188 Medicaid and CHIP Program (MACPro) (CMS-10434)
0938-1187 Initial Plan Data Collection to Support QHP Certification and other Financial Management and Exchange Operations (CMS-10433)
0938-1186 Home and Community-Based Services (HCBS) Experience Survey
0938-1185 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)
0938-1184 Minimum Data Set for Medicaid Incentives for Prevention of Chronic Diseases Program Grantees
0938-1183 Surveys of Physicians and Home Health Agencies to Assess Access Issues for Specific Medicare Beneficiaries as Defined in Section 3131(d) of the ACA
0938-1182 Analysis of Transportation Barriers to Utilization of Medicare Services by American Indian and Alaska Native Medicare Beneficiaries
0938-1181 Durable Medical Equipment Face-to-Face Requirements
0938-1180 For-Profit PACE Study
0938-1179 Medicare Enrollment Application- Reassignment of Medicare Benefits (CMS-855R)
0938-1178 Medicare Enrollment Application for Physician and Non-Physician Practitioners
0938-1177 Beneficiary and Family Centered Data Collection (CMS-10393)
0938-1176 Recognized Accrediting Entities Data Collection (45 CFR part 156.275)
0938-1175 PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program (CMS-10431)
0938-1174 Essential Health Benefits Benchmark Plans (CMS-10448)
0938-1173 Transparency Reports and Reporting of Physician Ownership or Investment Interests (CMS-10419)
0938-1172 Blueprint for Approval of Affordable State-based and State Partnership Insurance Exchanges
0938-1171 Inpatient Psychiatric Facility Quality Reporting Program (CMS-10432)
0938-1170 Payments for Services Furnished by Certain Primary Care Providers and Supporting Regulations in 42 CFR 438.6, 438.804, 447.400, and 447.410 (CMS-10422)
0938-1169 Fee-for-Service Recovery Audit Prepayment Review Demonstration and Prior Authorization Demonstration (CMS-10421)
0938-1168 Cooperative Agreement to Support Establishment of the Affordable Care Act's Health Insurance Exchanges
0938-1167 Community Based Care Transitions Program (CCTP) Implementation and Monitoring
0938-1166 Health Plan Identifier, Other Entity Identifier, and Change to National Provider Identifier Requirements
0938-1165 Nursing Home Quality Improvement Questionnaire
0938-1164 Medical Loss Ratio Annual Reports, MLR Notices, and Recordkeeping Requirements (CMS-10418)
0938-1163 Long Term Care Hospital (LTCH) Quality Reporting Program (CMS-10409)
0938-1162 Section 1115 Demonstration Projects Regulations at 42 CFR 431.408, 431.412, 431.420, 431.424, and 431.428 (CMS-10341)
0938-1161 Pre-Existing Condition Insurance Plan (PCIP) HIPAA Authorization Form
0938-1160 CMS National Balancing Indicators Project (NBIP) Direct Service Workforce (DSW) Data Collection Effort
0938-1159 Section 1115 Demonstration: Long Term Services and Supports and Other Service Models for Individuals with Disabilities and Chronic Conditions
0938-1158 (CMS-10336) Medicare and Medicaid Programs; Promoting Interoperability Program
0938-1157 Student Health Insurance Coverage (CMS-10377)
0938-1156 Establishment of Qualified Health Plans and American Health Benefit Exchanges (CMS-10400)
0938-1155 Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment (CMS-10401)
0938-1154 Medication Therapy Management Program Improvements - Standardized Format (CMS-10396)
0938-1153 Hospice Quality Reporting Program (CMS-10390)
0938-1152 Collection of Encounter Data from MA Organizations, Section 1876 Cost HMOs/CMPs, MMPs, and PACE Organizations (CMS-10340)
0938-1151 Medicaid Program; Medicaid State Plan Preprint for Use by States When Implementing Section 6401, Provider Screening and Other Enrollment Requirements Under Medicare, Medicaid and CHIP
0938-1150 Early Retiree Reinsurance Program: Survey of Plan Sponsors
0938-1149 Version 5010/ICD-10 Industry Readiness Assessment
0938-1148 Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)
0938-1147 Medicaid Program; Eligibility Changes under the Affordable Care Act of 2010 (CMS-10410)
0938-1146 Summary of Benefits and Coverage and Uniform Glossary (CMS-10407)
0938-1145 State Balancing Incentive Payments Program (BIPP)
0938-1144 Application to Be a Qualified Entity to Receive Medicare Data for Performance Measurement (CMS-10394)
0938-1143 Consumer Research on Public Reporting of Hospital Quality Measures (CMS-10360)
0938-1142 Autism Spectrum Disorders (ASD): State of the States in Services and Supports for People with ASD
0938-1141 Rate Increase Disclosure and Review Reporting Requirements (CMS-10379)
0938-1140 Minimum Data Set 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) for the Collection of Data Related to the Patient Driven Payment Model and the Skilled Nursing Facility QRP (CMS-10387)
0938-1139 Consumer Operated and Oriented Plan [CO-OP] Program (CMS-10392)
0938-1138 eRx Incentive Program Submission of Significant Hardship Exemption to Avoid the eRx Payment Adjustment
0938-1137 Letter Requesting Waiver of Medicare/Medicaid Enrollment Application Fee; Submission of Fingerprints; Submission of Medicaid Identifying Information; Medicaid Site Visit and Rescreening (CMS-10357)
0938-1136 Provider-Preventable Conditions under 42 CFR 438.6 and 447.26 and Title 2702 Non-Payment Preprint (Attachment 4.19)
0938-1135 Medicare Registration Application (CMS-855O)
0938-1134 Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204 (CMS-10391)
0938-1133 Disclosure Requirement for the In-Office Ancillary Services Exception (CMS-10332)
0938-1132 Medical Loss Ratio - Quarterly Reporting for Mini-med Plans and Expatriate Plans
0938-1131 Medicaid Emergency Psychiatric Demonstration
0938-1129 Appeals of Quality Bonus Payment Determinations (CMS-10346)
0938-1128 Medicaid State Plan Preprint for Use by States When Implementing Section 6505, the Prohibition on Payments to Institutions or Entities Located Outside of the United States
0938-1127 Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services (CMS-10344)
0938-1126 State Plan Preprint for Medicaid Recovery Audit Contractor (RAC) Program (CMS-10343)
0938-1125 Expedited Checklist: Medicaid Eligibility & Enrollment Systems - Advance Planning Document (E&E-APD ) (CMS-10385)
0938-1124 Medicare Community-based Care Transitions Program
0938-1123 MMIS APD Template for Use by States When Implementing the Mandatory National Correct Coding Initiative in Medicaid, implementation of Section 6507 of ACA (CMS-10358)
0938-1122 Current State Practices Related to Payments to Providers for Health Care-Acquired Conditions
0938-1121 Reporting Requirements for Grants to States for Rate Review Cycle IV and Effective Rate Review Program (CMS-10380)
0938-1120 Evaluation of Practice Models for Dual Eligibles and Medicare Beneficiaries with Serious Chronic Conditions
0938-1119 Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges (CMS-10371)
0938-1118 Preliminary Establishment for Territories Cooperative Agreements for the Affordable Care Act Exchanges
0938-1117 The Medicare Acute Care Episode Demonstration
0938-1116 Patient Safety Survey Under the 9th SOW: Nursing Home In Need (NHIN)
0938-1115 Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) (CMS-10305)
0938-1114 Medical Loss Ratio (IFR) Information Collection Requirements and Supporting Regulations (CMS-10361)
0938-1113 Implementation of the Medicare Prescription Drug Plan (PDP) and Medicare Advantage (MA) Plan Disenrollment Reasons Survey (CMS-10316)
0938-1112 Survey to Inform the Children's Health Insurance Program (CHIP) National Outreach & Education Campaign
0938-1111 Electronic Submission of Medicare Graduate Medical Education (GME) Affiliation Agreements (CMS-10326)
0938-1110 Cooperative Agreements to Support Innovative Exchange Information Technology Systems
0938-1109 Hospital Outpatient Quality Data Program (HOPQDRP) (CMS-10250)
0938-1108 Medicaid Savings Program Protection from Medicaid Estate Recovery -- State Plan Preprint Under Title 19 (CMS-10314)
0938-1107 Parts C and D Complaints Resolution Performance Measures
0938-1106 Medicare Self-Referral Disclosure Protocol(CMS-10328)
0938-1105 Process for Obtaining Waivers of the Annual Limits Requirements of PHS Act Section 2711
0938-1104 Program Evaluation of the Ninth Scope of Work Quality Improvement Organization Program (CMS-10294)
0938-1103 Medicare Gainsharing Demonstration Evaluation: Physician Focus Groups
0938-1102 Medicare Quality of Care Complaint Form (CMS-10287)
0938-1101 Limited Competition for State Planning and Establishment Grants for the Affordable Care Act's Exchanges
0938-1100 Pre-Existing Condition Insurance Plan and Supporting Regulations
0938-1099 Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-grandfathered Group Health Plans and Issuers and Individual Market Issuers (CMS-10338)
0938-1098 Tribal Consultation State Plan Amendment Template (CMS-10293)
0938-1097 Consumer Assistance Program Grants (CMS-10333)
0938-1096 Data Collection for Developing Outpatient Therapy Payment Alternatives (DOTPA)
0938-1095 Application for Coverage in the Pre-Existing Condition Insurance Plan
0938-1094 Notice of Rescission of Coverage and Disclosure Requirements for Patient Protection under the Affordable Care Act (CMS-10330)
0938-1093 Disclosure and Recordkeeping Requirements for Grandfathered Health Plans under the Affordable Care Act (CMS-10325)
0938-1092 Grants to States for Health Insurance Premium Review
0938-1091 (CMS-10282) Comprehensive Outpatient Rehabilitation Facilites (CORFs) Conditions of Participation (CoP) and Supporting Regulations
0938-1090 Electronic Health Records (EHR) Testing
0938-1089 Affordable Care Act Enrollment Opportunity Notice Relating to Extension of Dependent Coverage
0938-1088 Medicaid Promoting Interoperability Program Document Templates (CMS-10292)
0938-1087 Early Retiree Reinsurance Program
0938-1086 Health Care Reform Insurance Web Portal Requirements 45 CFR part 159 (CMS-10320)
0938-1085 Temporary High Risk Pool Program (CMS-10319)
0938-1084 Additional State Plan Option for Providing Premium Assistance State Plan Templates under Title XIX and XXI (CMS-10300)
0938-1083 Medicare Program/Home Health Prospective Payment System Rate Update for CY2010: Physician Narrative Requirement, CY2011 Final Physician Face-to-Face Encounter
0938-1082 Option to Cover Certain Children and Pregnant Women Lawfully Residing in the U.S. State Plan Amendment Template (CMS-10299)
0938-1081 Consumer Research on Public Reporting of Hospital Outpatient Measures (CMS-10310)
0938-1080 Medical Necessity Disclosure Under MHPAEA and Claims Denial Disclosure Under MHPAEA (CMS-10307)
0938-1079 Grandfathering Provisions of the Medicare DMEPOS Competitive Bidding Program
0938-1078 Collection Requirements for Compendia for Determination of Medically-Accepted Indications for Off-label Uses of Drugs and Biologicals in an Anti-Cancer Chemotherapeutic Regimen (CMS-10302)
0938-1077 Notice of Research Exception under the Genetic Information Nondiscrimination Act (CMS-10286)
0938-1076 State Plan Pre-print to Implement Required Dental Benefits Pursuant of CHIPRA 2009 (CMS-10288)
0938-1075 Optional Dental-only Supplemental Coverage SPA Template (CMS-10289)
0938-1074 Mandatory Insurer Reporting Requirements of Section 111 of the Medicare, Medicaid and SCHIP Act of 2007 (CMS-10265)
0938-1073 Recovery Act - Reporting Requirements for States Under FMAP Increase and TMA Provisions (CMS-10295)
0938-1072 Evaluation of the Medicare Care Management Performance Demonstration and the Electronic Health Records Demonstration
0938-1071 (CMS-10279) Ambulatory Surgical Centers Conditions of Coverage
0938-1070 State Plan Amendment Template for Transitional Medical Assistance for Low-Income Families (CMS-10283)
0938-1069 (CMS-10266) Conditions of Participation: Requirements for Approval and Reapproval of Transplant Centers to Perform Organ Transplants and Supporting Regulations
0938-1068 Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009, State Option Pre-print to Include Pregnant Women in Title XXI. (CMS-10284)
0938-1067 Hospice Conditions of Participation (CMS-10277)
0938-1066 CAHPS Home Health Care Survey (CMS-10275)
0938-1065 State Collection and Reporting of Dental Provider and Benefit Package Information on the Insure Kids Now! Website and Hotline (CMS-10291)
0938-1064 Evaluation of the Home Health Pay for Performance Demonstration: Survey instrument
0938-1063 National Medicare Training Program Needs Assessment Survey
0938-1062 Recovery Act of 2009 - Request for Review If You Have Been Denied Premium Assistance
0938-1061 Supplemental Appropriations Act of 1008 Mandated Report to Congress (CMS-10281)
0938-1060 Hospital Leadership Quality Assessment Tool (HLQAT)
0938-1059 Physician Quality Reporting System (PQRS) (CMS-10276)
0938-1058 Medicare Registration Summary and Medication History Personal Health Record Evaluation
0938-1057 Evaluation of the Medicare Care Management Performance Demonstration
0938-1056 Medicare Enrollment Application (Form 855S)
0938-1055 HIFA Evaluation Enrollee Survey (CMS-10262)
0938-1054 Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a) (CMS-10261)
0938-1053 Administrative Requirements for Section 6071 of the Deficit Reduction Act of 2005 (CMS-10249)
0938-1052 (CMS-10268) Consolidated Renal Operations in a Web Enabled Network (CROWNWeb) Third-party Submission Authorization Form
0938-1051 Medicare Advantage and Prescription Drug Program: Final Marketing Provisions CFR 422.111(a)(3) and 423.128(a)(3) (CMS-10260)
0938-1050 QualityNet Identity Management System (QIMS) Account Form
0938-1049 Emergency Ambulance Transports and Beneficiary Signature Requirements in 42 CFR 424.36(b) (CMS-10242)
0938-1048 Evaluation of Care and Disease Management Under Medicare Advantage
0938-1047 State Plan Pre-print for Integrated Medicare and Medicaid Programs (CMS-10251)
0938-1046 Certificate of Data Destruction for Data Acquired from the Centers for Medicare and Medicaid Services
0938-1045 State Plan Template to Implement Section 6062 of the DRA (Opportunity for Families of Disabled Children to Purchase Medicaid Coverage for Such Children) CMS-10232
0938-1044 Submission of Information for the Hospital Outpatient Quality Data Program
0938-1043 (CMS-10239) Conditions of Participation for Critical Access Hospitals and Supporting Regulations
0938-1042 HCPCS Modification to Code Set Form (CMS-10224)
0938-1041 Survey of Retail Prices (CMS-10241)
0938-1040 Testing of Revised OASIS Instrument for Home Health Quality Measures & Data Analysis
0938-1039 Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration
0938-1038 Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration
0938-1037 Testing Experience and Functional Tools: Functional Assessment Standardized Items (FASI) Based on the CARE Tool (CMS-10243)
0938-1036 Survey of Contract Labor in Selected Health Industries
0938-1035 Provider Enrollment Chain and Ownership System (PECOS) Web Security Consent Form (CMS-10220)
0938-1034 Disclosures Required Regarding Physician Ownership and On-site Availability of an MD/DO (CMS-10225)
0938-1033 Medicaid State Program Integrity (SPIA) CMS-10244
0938-1032 Regional PPO Risk-Sharing Reconciliation Cost Report
0938-1031 Physician Survey for the 2006 Medicare Oncology Demonstration Program
0938-1030 Medicare Competitive Acquisition Program (CAP) for Part B Drugs Evaluation: CAP Physician Survey
0938-1029 Worksheet for Recording Results of Medicare Site Visits of Independent Diagnostic Testing Facilities (IDTFs) (CMS-10221)
0938-1028 HEDIS Data Collection for Medicare Advantage (CMS-10219)
0938-1027 PACE State Plan Amendment Pre-print (CMS-10227)
0938-1026 Identifying Medicaid Payment for Physician Administered Drugs (CMS-10215)
0938-1025 Evaluation of the Medical Adult Day-Care Services Demonstration - Phase I
0938-1024 State Plan Pre-print implementing Section 6087 of the DRA: Optional Self Direction PAS Program (Cash and Counseling) CMS-10234
0938-1023 Medicare Advantage Chronic Care Improvement Program (CCIP) Attestations (CMS-10209)
0938-1022 Hospital Reporting Initiative--Hospital Quality Measures (CMS-10210)
0938-1021 Assessing Degrees of Health Care Involvement Survey
0938-1020 Requests by Hospitals for an Alternative Cost-to-Charge Ratio (CMS-10179)
0938-1019 Hospital Notices: Important Message from Medicare (IM) and Detailed Notice of Discharge (DND) (CMS-10065/10066)
0938-1018 Evaluation of the Medical Adult Day-Care Services Demonstration - Phase I
0938-1017 Evaluation of the Medical Adult Day Care Services Demonstration
0938-1016 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program
0938-1015 Evaluation of Medicare National Competitive Bidding Program for DME
0938-1014 Data Collection for Administering the Medicare Health Improvement Survey
0938-1013 Creditable Coverage Disclosure to CMS OnLine Form and Instructions (CMS-10198)
0938-1012 Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (CMS-10184)
0938-1011 (CMS-10199) Data Collection for Medicare Beneficiaries Receiving Carotid Artery Stenting with Embolic Protection
0938-1010 Mail Survey of Medicare Advantage Special Needs Plans / Focus Groups with Enrollees of Medicare Advantage SNPs
0938-1009 Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)
0938-1008 Medicare Clinical Laboratory Services Competitive Bidding Demonstration Project : Bidding Form
0938-1007 Alternative Benefits State Plan Amendment Health Opportunity Accounts Demonstration Program (CMS-10216)
0938-1006 Evaluation of Home Health Independence Demonstration: Home Health Agency Survey
0938-1005 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Accreditation Proposals from Independent Accrediting Bodies
0938-1004 Medicare Part C Audit Guide, Version 4 contained in 42 CFR 423.502
0938-1003 National Evaluation of the Demonstration to Improve the Direct Service Community Workforce
0938-1002 Evaluation of the Medicare Audit Recovery Audit Contractor Demonistration and RAC Provider Satisfaction Survey
0938-1001 Voluntary Sample AMP Collection
0938-1000 Medicare Parts C and D Program Audit Protocols and Data Requests (CMS-10191)
0938-0999 Insurance Common Claims Form and Supporting Regulations at 42 CFR Part 424 Subpart C
0938-0998 Evaluation of the Demonstration of Coverage of Chiropractic Services Under Medicare
0938-0997 Health Insurance Claims Form, UB-04 CMS 1450
0938-0996 Enrolling Low-Income Beneficiaries into the Medicare Prescription Drug Program Survey of State Agency Experiences
0938-0995 Disclosure of Financial Relationships Report ("DFRR") - Section 5006 of the DRA
0938-0994 Payment Error Rate Measurement in Medicaid & Children's Health Insurance Program (CHIP)
0938-0993 State Plan preprints to implement Sections of the Deficit Reduction Act of 2006 (CMS-10190)
0938-0992 Medicare Part D Reporting Requirements and Supporting Regulations in MMA Title I, Part 423, §423.514(a) (CMS-10185)
0938-0990 Model Creditable Coverage Disclosure Notices
0938-0989 Individuals Authorized Access to the CMS Computer Services
0938-0988 State Children's Health Insurance Program (SCHIP) Report on Payables and Receivables (CMS-10180)
0938-0987 Competitive Acquisition Program (CAP) for Medicare Part B Drugs: CAP Physician Election Agreement
0938-0986 (CMS-437A and 437B) Rehabilitation Unit Criteria Work Sheet and Rehabilitation Hospital Criteria Work Sheet and Supporting Regulations
0938-0985 Medicare Health Support Program Medical Records Abstraction
0938-0984 Certification Statement for Electronic File Interchange Organizations that Submit NPI Data to the National Plan and Provider Enumeration System (CMS-10175)
0938-0983 Medicare EDI Enrollment Form and EDI Registration
0938-0982 Collection of Prescription Drug Data from MA-PD, PDP and Fallout Plans/Sponsors for Medicare Part D Payments (CMS-10174)
0938-0981 National Implementation of Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) (CMS-10102)
0938-0980 Medicare Care Improvement Survey
0938-0979 New Freedom Initiative - Web-based Reporting System for Grantees (CMS-10161)
0938-0978 Part D Coordination of Benefits Data (CMS-10171)
0938-0977 Retiree Drug Subsidy Payment Request Instructions (CMS-10170)
0938-0976 Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146)
0938-0975 Medicare Prescription Drug Coverage and Your Rights (CMS-10147)
0938-0974 Payment Error Rate Measurement in Medicaid and the State Children Health Insurance Program (CMS-10166)
0938-0973 Physician Assessment of Hospital Quality Reports
0938-0972 Consumer Assessment of Health Behaviors Survey
0938-0971 (CMS-10116) Medicare Program: Conditions of Payment of Power Mobility Devices, Including Power Wheelchairs and Power-Operated Vehicles
0938-0969 Medicare Fee-for-Service Early Review of Medical Records (CMS-10417)
0938-0968 (CMS-10152) Data collection for Medicare Beneficiaries Receiving FDG Positron Emission Tomography (PET) for Brain, Cervical, Ovarian, Pancreatic, Small Cell Lung, and All Other Cancers
0938-0967 (CMS-10151) Data Collection for Medicare Beneficiaries Receiving Implantable Cardioverter-defibrillators for Primary Prevention of Sudden Cardiac Death
0938-0965 Electronic Health Records (EHR) Demonstration System (EHRDS) - practice application and profile update system
0938-0964 Comprehensive Addiction and Recovery Act of 2016 (CARA) / Medicare Prescription Drug Benefit Program (CMS-10141)
0938-0963 1-800-MEDICARE Customer Experience Questionnaire
0938-0960 CMS Real-Time Eligibility Agreement and MDCN Access Request
0938-0959 HCAHPS Cost Information
0938-0958 Monthly State File of Medicaid/Medicare Dual Eligible Enrollees (CMS-10143)
0938-0957 Retiree Drug Subsidy (RDS) Application and Instructions (CMS-10156)
0938-0956 Beneficiary Survey on the Medicare Home Health Independence Demonstration
0938-0955 Medicare Part B Drug and Biological Competitive Acquisition Program Applications
0938-0954 Medicare Part B Drug and Biological Competitive Acquisition Program and Supporting Regulations in 42 CFR Sections 414.906, 414.908, 414.910, 414.914, 414.916, and 414.917
0938-0953 Notice of Provider Non-Coverage (CMS-10123) and Detailed Explanation of Non-Coverage (CMS-10124)
0938-0952 Federal Funding of Emergency Health Services (Section 1011); Provider Payment Determination and On-Call Cost Forms
0938-0951 Collection of Drug Pricing and Network Pharmacy Data from Medicare Prescription Drug Plans (PDP and MA-PD) and Supporting Regulations in 42 CFR 423.48
0938-0950 Appointment of Representative and Supporting Regulations in 42 CFR 405.910 (CMS-1696)
0938-0949 Health Insurance Reform Security Standards - Final Rule
0938-0948 HIPAA Administrative Simplification Non-Privacy Enforcement
0938-0944 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10142)
0938-0943 Evaluation of Medicare Disease Management Demonstrations
0938-0942 Physician Group Practice (PGP) Standardized Ambulatory Care Quality Measure Collection Initiative
0938-0941 Medicare Demonstration Ambulatory Care Quality Measure Performance Assessment Tool ("PAT")
0938-0940 OASIS Study: OASIS Cost and Benefit Survey of Home Health Agencies and Supporting Regulations 42 CFR Parts 484 and 488
0938-0939 Phone Surveys of Product/Service for Medicare Payment Validation and Supporting Regulations in 42 CFR, 405.502
0938-0938 Public Reporting on Quality Outcomes National Survey of Hospital Executives ("PRO QUO")
0938-0937 Beneficiary Survey on the Medicare Drug Replacement Demonstration
0938-0936 Solicitation for Applications for Medicare Prescription Drug Plan 2022 Contracts (CMS-10137)
0938-0935 Applications for Part C Medicare Advantage, 1876 Cost Plans, and Employer Group Waiver Plans to Provide Part C Benefits (CMS-10237)
0938-0934 Religious Nonmedical Health Care Institutions (RNHCI) and Supporting Regulations in 42 CFR Section 403.766
0938-0933 1932 State Plan Amendment Template (CMS-10120)
0938-0932 Evaluation of PACE as a Permanent Program and a For Profit Demonstration
0938-0931 National Provider Identifier (NPI) Application and Update Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR 162.406 (CMS-10114)
0938-0930 Medicare Authorization to Disclose Personal Health Information (CMS-10106)
0938-0929 FEDERAL REIMBURSEMENT OF EMERGENCY HEALTH SERVICES FURNISHED TO UNDOCUMENTED ALIENS (SECTION 1011) PROVIDER ENROLLMENT APPLICATION
0938-0926 In-Center Hemodialysis CAHPS Survey (CMS-10105)
0938-0925 Grants to State Phamaccurical Assistance Program (SPAP)
0938-0924 Application for Participation in Medicare Replacement Drug Demonstration
0938-0922 Instrument/tool for refinement of a prospective payment system for patients in inpatient psychiatric hospitals, and units: a pilot test
0938-0921 Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biological and Supporting Regulations (CMS-10110)
0938-0920 Medicaid Managed Care and Supporting Regulations (CMS-10108)
0938-0919 1-800-MEDICARE Beneficiary Satisfaction Survey (CMS-100098)
0938-0918 National Voluntary Hospital Reporting Initiative--Hospital Quality Measures
0938-0917 Survey of Medicare Preferred Provider Organization Demonstration
0938-0916 (CMS-10053) Paid Feeding Assistants in Long Term Care Facilities and Supporting Regulations
0938-0915 Medicare Contractor Provider Satisfaction Survey (MCPSS) and Supporting Regulations in 42 CFR 421.120, 421.122 and 421.201
0938-0913 Medicare Drug Payment Exceptions Process
0938-0912 Medicare Health Survey (MHS)
0938-0911 Review of National Coverage Determinations and Local Coverage Determinations and Supporting Regulations in 42 CFR, Sections 426.400 and 426.500
0938-0910 Detailed Explanation of Non-Coverage (42 CFR 422.626(e)(1)), and Notice of Medicare Non-Coverage (42 CFR 422.624(b)(1))
0938-0909 Medicare Endorsed Prescription Drug Discount Card and Transitional Low-Income Assistance Program Response Form
0938-0907 Hospital Wage Index Occupational Mix Survey(CMS-10079)
0938-0906 Evaluation of the Medicaid Health Reform Demonstrations
0938-0905 Accepting New Patients Indicator UPIN (Unique Physician Identification Number) Participating Physicians Directory
0938-0903 CMS/AoA Aging and Disability Resource Center Grant Program (Real Choice Systems Change Grants for Community Living and the Older Americans Act, Public Law 106-501 (Catalog of Federal Domestic...
0938-0902 Evaluation of the Illinois and Wisconsin State Pharmacy Assistance Waivers
0938-0901 Real Choice Systems Change Grants for Community Living: Included the following ten separate grants: Feasibility Studies and Development Grants 1. Respite for Adults; 2. Respite for......
0938-0900 MSInteractive Survey Tool for cms.hhs.gov website
0938-0899 Data Collection for Administering The PACE Health Survey To Beneficiaries Enrolled In The Dual Eligible Demonstrations, Minnesota Senior Health Options and Minnesota Disability Health..
0938-0898 CMSO Survey of States: Performance Measurement Reporting Capability
0938-0897 Notification of MACs and CMS of Co-Located Medicare Providers
0938-0896 Demonstration to Improve the Direct Service Workforce
0938-0895 Medicare Part A Provider and Durable Medical Equipment Supplier Satisfaction Study
0938-0894 Medicare Ombudsman Customer Service Feedback Survey (CMS-10068)
0938-0893 Data Collection for Administering the Survey for the Evaluation of the Demonstration to Maintain Independence and Employment (DMIE)
0938-0892 Publication Usage Survey
0938-0891 Pilot Test of Hospital CAHPS Survey
0938-0890 Design and Implementation of a Targeted Beneficiary Survey on Access to Physician Services Among Medicare Beneficiaries
0938-0889 Pharmacy Plus Template Application
0938-0888 Survey of Rural Medicare Provider Education Needs
0938-0887 Matching Gants to States for the Operation of High Risk Pools and Supporting Regulations at 42 CFR 148.316, 148.318, and 148.320 *CMS-10078)
0938-0885 Medicare-Endorsed Prescription Drug Card Assistance Initiative
0938-0883 Standards for Privacy of Individually Identifiable Health Information and Supporting Regulations at 45 CFR Parts 160 and 164
0938-0882 Medicare Endorsed Prescription Drug Card Assistance Initiative
0938-0880 (CMS-10069) Medicare/Medicaid Demonstration/Model Application
0938-0879 Making Good Choices Survey
0938-0878 Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments (CMS-10062)
0938-0877 Evaluation of Programs of Coordinated Care and Disease Management
0938-0876 Evaluation of the MassHealth Insurance Partnership
0938-0875 Durable Medical Equipment Regional Carrier, Certificate of Medical Necessity and Supporting Documentation Requirements
0938-0874 HIPAA Standard Unique Employer Identifier and Supporting Regulations in 45 CFR Part 160 and 162
0938-0873 Quality Assessment and Performance Improvement (QAPI) Project Completion Report 42 CFR 422.152
0938-0872 Minimum Data Set (MDS) For Swing Bed Hospitals and Supporting Regulations in 42 CFR 483.20 and 413.337
0938-0871 Medicare Lifestyle Modification Program Demonstration
0938-0869 Survey of Newly Eligible Medicare Beneficiaries
0938-0868 Administration Demonstration Initiatives Proposal Solicitation Package
0938-0867 Survey of Medicare Private Fee-for-service (PFFS) Enrollees and Nonenrollees
0938-0866 ICRs Contained in 45 CFR Part 162; HIPAA Standards for Electronic Transactions
0938-0864 Medicare Current Beneficiary Survey -- Supplement on Patient Activation
0938-0863 Evaluation of the BadgerCare Medicaid Demonstration
0938-0862 Medicare Lifestyle Modification Program Demonstration
0938-0860 New Technology Services for Ambulatory Payment Classifications under the Outpatient Prospective Payment System (CMS-10054)
0938-0859 NMEP Regional Survey of Medicare Beneficiaries
0938-0857 Recognition of Pass-Through Payment for Additional (New) Categories of Devices Under the Outpatient Prospective Payment System and Supporting Regulations (CMS-10052)
0938-0855 Upper Payment Limits Reporting Requirements and Supporting Regulations Contained in 42 CFR 447.272 and 447.321
0938-0852 Durable Medicare Equipment and Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Survey: Texas
0938-0851 Assessing the CMS Fall Campaigns
0938-0850 State Health Insurance Assistance Program (SHIP) Client Contact Form, Pubic and Media Activity Form, and Resource Report Form
0938-0848 Health Insurance Flexibility and Accountability Section 1115 Model Waiver
0938-0847 Long-Term Care Awareness Campaign Demonstration Project
0938-0846 Physicians' Referrals to Health Care Entitles With Which They Have Financial Relationships and Supporting Regulations in 42 CFR, Sections 411.352, 411.354,411.355,411.357 and 411.361
0938-0845 "Medicare Endorsed Rx Discount Card Initiative
0938-0844 Medicare Health Survey (MHS) and Data Collection for Administering the PACE Health Survey to Beneficiaries Enrolled in PACE and the Dual Eligible Demonstrations
0938-0843 Healthy Aging Smoking Cessation Demonstration
0938-0842 Inpatient Rehabilitation Assessment Instrument and Data Set for PPS for Inpatient Rehabilitation Facilities (CMS-10036)
0938-0841 State Children's Health Insurance Program and Supporting Regulations (CMS-R-308)
0938-0840 Collection of Data on Quality Indicators for Congestive Heart Failure Submitted by Medicare+Choice Organizations Requesting Extra Payments in CY2002 and CY2003 and Supporting Regulations...
0938-0839 National Medicare Practitioner and Provider Survey
0938-0838 Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments
0938-0837 Medicare Program Integrity Customer Satisfaction Project
0938-0836 Real Choice Systems Change Grants; Nursing Facility Transition/ Access Housing Grants; Community Personal Assistance Service and Supports Grants, National Technical Assistance and Learning.....
0938-0834 Durable Medical Equipment and Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Survey
0938-0833 Restraint and Seclusion Standards for Psychiatric Residential Treatment Facilities (CMS-R-306)
0938-0832 Health Insurance Benefit Agreement and Supporting Regulations (CMS-1561/1561A)
0938-0829 Notice of Denial of Medical Coverage (or Payment) (NDMCP) (CMS-10003)
0938-0828 Medicare Beneficiary Customer Service Survey
0938-0827 HIPAA Nondiscrimination Provisions
0938-0826 Survey of Medicaid Home and Community-Based Services Waiver and Personal Care Option Recipients for the Multi-Site Study of Medicaid HOme and Community-Based Services
0938-0825 Stages of Change Survey for Informed Choice in the Medicare Population
0938-0824 Restraints/Seclusion Death Reporting for Hospitals and Supporting Regulations at 42 CFR 482.13
0938-0823 Suggestion Program on Methods to Improve Medicare Efficiency and Supporting Regulations in 42 CFR 420.410
0938-0820 Follow-Up of Medicare+Choice Disenrollees Receiving Fee-for-Service Inpatient Hospital Care
0938-0819 HIPAA Nondiscrimination Provisions (Regulation HCFA-2078-F)
0938-0818 (CMS-R-247) Expanded Coverage for Diabetes Outpatient Self-Management Training Services and Supporting Regulations
0938-0817 Survey of Medicare Beneficiaries Who Involuntarily Disenroll From Their Health Plan
0938-0813 Evaluation of the OMB and SLMB Programs -- Beneficiary Survey
0938-0812 Employee Building Pass Application and File
0938-0811 Ticket to Work and Work Incentives: Medicaid Infrastructure Grants
0938-0810 Hospital Condition of Participation; Identification of Potential Organ, Tissue, & Eye Donors & Transplant Hospitals' Provision of Transplant-Related Data & Supporting Regulation at 42 CFR 482.45
0938-0808 Study to Support Development and Refinement of a Classification System and Prospective Payment System for Patients in Inpatient Rehabilitation Hospitals and Exempt Rehabilitation Units
0938-0807 Oxygen Consumer Survey: Medical Equipment and Supplies
0938-0806 Informatics, Telemedicine, and Education Demonstration Project
0938-0805 Collection of Data on Physician Encounters from Medicare + Choice Organizations
0938-0804 Medicare DMEPOS Competitive Bidding Demonstration: Follow-up to Original Survey
0938-0802 Transitional Pass through payments related to Drugs, Biologicals, and Radiopharmaceuticals to determine eligibility under the Outpatient Prospective Payment System (CMS-10008)
0938-0801 Evaluation of QMB and SLMB Outreach Activities
0938-0800 Application Requirements: Solicitation for Proposals for the Medicare Coordinated Care Demonstration
0938-0799 TWWIA Demonstration to Maintain Independence and Employment
0938-0798 Prospective Payments for Hospital Outpatient Services and Supporting Regulations in 42 CFR 413.65 (CMS-R-240)
0938-0797 Individual Market-Guarantee Issue Election Packet, Supporting Regulations 45 CFR 148, and forms/instruction
0938-0796 Medicare Consumer Assessment of Health Plan Survey-Fee For Service (CAHPS-FFS)
0938-0795 Conflict of Interest and Ownership and Control Informaiton
0938-0794 Health Care Services for Deaf and Hard of Hearing Adults - Case Story Forms
0938-0792 Refinement of RHC Certification and QAPI and Supporting Regulations in 42 CFR 491.8 and 491.11
0938-0791 A Project to Develop an Outcome-ased Continuous Quality Improvement System and Core Outcome and Comprehensive Assessment Data Set for PACE
0938-0790 Medicare and Medicaid; Programs For All-Inclusive Care For The Elderly (PACE) Contained in 42 CFR Part 460 (CMS-R-244)
0938-0789 Survey and Evaluation of New Members of Medicare+Choice Plans
0938-0787 Request for Employment Information (CMS-R-297/CMS-L564)
0938-0786 External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364 (CMS-R-305)
0938-0785 HCFA Day One Information Collection
0938-0784 Flexibility in Payment Methods for Hospitals, Nursing Facilities, Supporting Regualtions in 42 CFR 447.254
0938-0783 Market Survey of Fraud, Waste, and Abuse Detection Software
0938-0782 Multi-State Evaluation of Dual Eligibles Demonstrations: Wisconsin Partnership Program
0938-0781 Home Health Advance Beneficiary Notices and Supporting Regulations in 42 CFR, Section 411.404 and 484.10(a) and (e)
0938-0780 Medicare Telephone Customer Satisfaction Survey
0938-0779 Medicare CAHPS Disenrollment Surveys and Supporting Regs. in 42 CFR 417.126, 417.470, 422.64, and 422.210
0938-0778 Medicare Health Plan Appeals and Grievance Data Collection and Reporting Requirements, Data Disclosure Requirements under section 422.111 (CMS-R-282)
0938-0777 Medicare Lifestyle Modification Program Demonstration and Addendum
0938-0776 (CMS-R-290) Medicare Program: Process for Making National Coverage Determinations
0938-0775 National Hospital Malpractice Insurance Survey (NHMIS)
0938-0774 Medicare Competitive Pricing Demonstration Bid Solicitation Package for Kansas City
0938-0773 Bounceback Forms for www.Medicare.gov/nmep
0938-0772 Peer Review Evaluation of Access to and Quality of Home Oxygen Equipment
0938-0771 Survey of Medicare Beneficiaries for the National Medicare and You Handbook: 2000 Evaluation
0938-0770 Community Mental Health Center Site Visit Assessment Tool and Supporting Regulations in 42 CFR 410.2
0938-0769 Request for Retirement Benefit Information (CMS-R-285)
0938-0768 Medicare Agreement Application, Health Care Prepayment Plan and Supporting Regulations in 42 CFR, Section 417.800-.840
0938-0767 Medigap Compare
0938-0766 Feedback Postcard
0938-0765 Evaluation of Medicare+Choice Medical Savings Account Demonstration; Insurer Survey Component
0938-0764 Publication Information Sheet Reorder Form Feedback Questionnaire
0938-0763 The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs) (CMS-R-262)
0938-0761 Medicare and Medicaid Programs: Use and Reporting of OASIS Data as Part of the CoPs for HHAs and Supporting Regulations in 42 CFR 484.11 and 484.20
0938-0760 OASIS Collection Requirements as Part of the CoPs for HHAs and Supporting Regulations
0938-0759 Medicare Beneficiary Information Needs: Supplement to the Medicare Current Beneficiary Survey (MCBS)
0938-0758 Hospice FacilityCost Report
0938-0757 Managed Care Organization Year 2000 Continuity and Contingency Planning
0938-0756 MSInteractive Survey Tool for www.medicare.gov
0938-0755 Oxygen Consumer Survey: Medical Equipment and Supplies Consumer Survey
0938-0754 Inpatient Psychiatric Services for Individuals Under Age 21 and Supporting Regs.
0938-0753 Medicare Advantage Program and Supporting Regulations (CMS-R-267)
0938-0752 Evaluation of the EverCare Demonstration Program
0938-0751 Medicare Current Beneficiary Survey: National Baseline Medicare Beneficiary Knowledge Supplement
0938-0750 Best Practices in Coordinated Care
0938-0749 On-Site Inspection for Durable Medical Equipment (DME) Supplier Location and Supporting Regulations in 42 CFR, Section 424.57 (CMS-R-263)
0938-0748 Medicare DMEPOS Competitive Bidding Demonstration
0938-0746 Medicaid Disproportionate Share Hospital Annual Reporting (CMS-R-266)
0938-0745 Quality Improvement System for Managed Care (QISMC) Standards and Guidelines
0938-0742 Adjusted Community Rate (ACR) Proposal Medicare+Choice 42 CFR 422.300-422.312
0938-0741 Medicare Advantage & Part D Disenrollment Requests Through 1-800-MEDICARE
0938-0740 Bounceback Form for Medicare and You on WWW.Medicare.Gov
0938-0739 MPAF Data and Supporting Regulations in 42 CFR Sections 413.337, 413.343, 424.32 and 483.20
0938-0738 National Medical & You Education Program (NMEP) Survey of Medicare Beneficiaries
0938-0737 Call-Back Survey of Callers to the Medicare+Choice Toll-Free Hotline
0938-0736 Multi-State Evaluation of the Dual Eligible Demonstration
0938-0734 Data Use Agreement Information Collection Requirements, Model Language, and Supporting Regulations in 45 CFR Section 5b
0938-0733 Waiver Requirements and Solvency Standards for Provider-Sponsored Organizations -- 42 CFR 422.350-.390
0938-0732 Medicare Advantage, Medicare Part D, and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey (CMS-R-246)
0938-0731 Quarterly Children's Health Insurance Program Statement of Expenditures for Title XXI (CMS-21 and 21B)
0938-0730 Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410, 405.430, 405.435, 405.440, 405.445, 405.455, 410.61, 415.110, and 424.24 (CMS-R-234)
0938-0727 Evaluation of the Oregon Medicaid Reform Demonstration: Phase II Adult Interview, Phase II Child Interview, Survey of Agency Providers
0938-0726 Evaluation of the Medicare Choices Demonstrations
0938-0725 Medicare Physician Communication Survey
0938-0723 Medicare Integrity Program Organizational Conflict of Interest Disclosure Certificate and Supporting Regs at 42 CFR 421.300- 421.316
0938-0722 Medicare+Choice Provider Sponsored Organization Waiver Request Form and Supporting Regulations at 42 CFR 422.370 through 422.378
0938-0721 Independent Diagnostic Testing Facility and Supporting Regulations Contained in 42 CFR 410.33
0938-0720 Development of an Assessment System for Post Acute Care
0938-0719 Mental Health Parity Act of 1996: Information Collection Requirements Contained in HCFA-2891-IFC -- 45 CFR 146.136
0938-0718 Research and Analytic Support for Implementing Performance Measurement in Medicare Fee for Service
0938-0717 Information Collection Requirements Referenced in 42 CFR Sec. 424.57; Additional DMEPOS Supplier Standards
0938-0715 End-Stage Renal Disease Managed Care Demonstration Evaluation
0938-0714 Issuance of Advisory Opinions Concerning Physicians' Referrals (CMS-R-216)
0938-0713 Surety Bond Requirements for Home Health Agencies (HHA) -- 42 CFR Section 441.16, 489.66, and 489.67
0938-0712 Survey of Primary Caregivers for the District of Columbia's Managed Care Demonstration for Disabled and Special Needs Children
0938-0711 Managed Care Data Using the Uniform Institutional Providers Form
0938-0710 Evaluation of the Oregon Medicaid Reform Demonstration: Adult Interview, Child Interview, Pediatric Asthma Interview, Insulin- Dependent Diabetes Interview, Low Back Pain Interview Medical....
0938-0709 Data Collection for the Second Generation Social Health Maintenance Organization Demonstration
0938-0708 Evaluation of the State Medicaid Reform Demonstrations and Evaluation of the Medicaid Health Reform Demonstrations
0938-0707 Model Application Template for State Child Health Plan Under Title XXI of the Social Security Act, State Children's Health Insurance Program, & Model Application Template & Instructions (CMS-R-211)
0938-0705 Maximizing the Effective Use of Telemedicine: A Study of the Effects, Cost Effectiveness and Utilization Patterns of Consultations via Telemedicine
0938-0704 Data Collection Forms for a Project to Develop a Case-Mix Adjustment System for a National Home Health Prospective Payment Program
0938-0703 Information Collection Requirements Referenced in HIPAA for the Individual Market, Supporting Regulations 45 CFR 148, and Forms/Instructions
0938-0702 Compliance with Individual and Group Market Reforms under Title XXVII of the Public Health Service Act (CMS-10430)
0938-0701 Medicare Health Outcomes Survey (HOS) (CMS-10203)
0938-0700 Incentive Arrangement Disclosure Form and Supporting Regulations 42 CFR 417.479, 417.500, 422.208, 422.210, 434.44, 434.67, 434.70, 1003.100, 1003.101, 1003.103, 1003.106
0938-0699 Notification Procedures for States Implementing Alternative Mechanisms in the Individual Health Insurance Market and Supporting Notice -- BPD-882-N
0938-0698 Hospital Standards for Potentially HIV Infectious Blood and Blood Products -- 42 CFR 482.27
0938-0697 Medicaid Report on Payables and Receivables (R-199)
0938-0694 Evaluation of the Per-Episode Home Health Prospective Payment Demonstration
0938-0693 Federally Qualified Health Center (FQHC) Survey
0938-0692 Medicare and Medicare Advantage Programs; Notification Procedures for Hospital Discharges: Important Message From Medicare (CMS-R-193)
0938-0691 Medicare Disproportionate Share Adjustment Procedures (CMS-R-194)
0938-0690 Granting and Withdrawal of Deeming Authority to National Accreditation Organizations and Supporting Regulations at 42 CFR 488.4-488.9, and 488.201
0938-0688 (CMS-R-13) Conditions of Coverage for Organ Procurement Organizations (OPOs) and Supporting Regulations
0938-0687 Maximizing the Effectiveness of Home Health Care: The Influence of Service Volume and Integration with Other Care Settings on Patient Outcomes
0938-0686 (CMS-R-185) Granting and Withdrawal of Deeming Authority to Private Nonprofit Accreditation Organizations and of State Exemption Under State Laboratory Programs and Supporting Regs)
0938-0685 Medicare Enrollment Application for Institutional Providers (CMS-855A)
0938-0684 National Provider System
0938-0683 Evaluation of the Medicare Cataract Surgery Alternate Payment Demonstration
0938-0682 Data Collection and Analysis for Generating Procedure-Specific Cost Estimates
0938-0681 Evaluation of the Oregon Medicaid Reform Demonstration, Baseline Survey
0938-0680 Field Testing of the Uniform Needs Assessment Instrument (UNAI): Small-Scale Trial Phase 2
0938-0679 Durable Medical Equipment Medicare Administrative Contractors (MAC) Regional Carrier, Certificate of Medical Necessity and Supporting Documentation
0938-0678 Evaluation of Intermediate Care Facilities for Persons with Mental Retardation
0938-0677 Study of the Cost of Administering Childhood Immunizations -- HCFA-17-C-90379/3-1
0938-0676 Reconciliation of State Invoice (ROSI) (CMS-304) and Prior Quarter Adjustment Statement (PQRS) (CMS-304a)
0938-0675 Quality Assurance for Phase II of the Home Health Agency Prospective Payment Demonstration
0938-0674 Targetted Race and Ethnicity Survey
0938-0673 Medicaid Post-Eligibility Preprint--And Supporting Regulations at 42 CFR 430.10
0938-0671 EVALUATION OF THE DRUG USE REVIEW DEMONSTRATIONS PROJECTS
0938-0670 Criteria for Medicare Coverage of Lung Transplants
0938-0669 DIALYSIS UNIT HEALTH CARE QUALITY IMPROVEMENT PROGRAM SURVEY
0938-0667 Examination and Treatment for Emergency Medical Conditions and Women in Labor (EMTALA), 42 CFR 482.12, 488.18, 489.20, and 489.24 (R-142)
0938-0665 MEDICARE TECHNICAL ADVISORY GROUP (M-TAG) BENEFICIARY SURVEY
0938-0664 EVALUATION OF PATIENT AND PHYSICIAN SATISFACTION WITH THE MEDICARE PARTICIPATING HEART BYPASS CENTER DEMONSTRATION
0938-0663 EXAMINATION AND TREATMENT OF EMERGENCY MEDICAL CONDITIONS AND WOMEN IN LABOR AND 42 CFR 489.24 ESSENTIALS OF PROVIDER AGREEMENT RESPONSIBILITIES OF MEDICARE PARTICIPATING....
0938-0662 Evaluation of the Program of All-Inclusive Care for the Elderly (PACE) Demonstration
0938-0660 VOLUNTARY "PARTNER/REGULATED ENTITY" CUSTOMER SURVEYS TO IMPLEMENT EXECUTIVE ORDER 12862 WITHIN HCFA
0938-0659 Medicaid Drug Utilization Review (DUR) Program (CMS-R-153)
0938-0658 End-Stage Renal Disease (ESRD) Network Business Proposal Forms and Supporting Regulations in 42 CFR 405.2110 and 42 CFR 405.2112
0938-0657 (CMS-685) End-Stage Renal Disease (ESRD) Network Semi-Annual Cost Report Forms and Supporting Regulations
0938-0656 EVALUATION OF MEDICARE SELECT AMENDMENTS
0938-0655 Clinical Laboratory Improvement Amendments (CLIA) Adverse Action Extract and Supporting Regulations at 42 CFr 493.1840
0938-0654 Post Laboratory Survey Questionnaire, Surveyor
0938-0653 Post Cinical Laboratory Survey Questionnaire and Supporting Regulations in 42 CFR 493.1771, 483.1773, and 493.1777 (CMS-668B)
0938-0652 VOLUNTARY CUSTOMER SURVEYS TO IMPLEMENT E.O. 12862 WITHIN THE HEALTH CARE FINANCE ADMINISTRATION (HCFA)
0938-0651 MEDICARE AND MEDICAID COVERAGE DATA BANK REPORTS
0938-0650 Alternate Quality Assessment Survey
0938-0649 BENEFICIARY SURVEY FORM
0938-0648 EVALUATION OF THE MEDICAID UNINSURED DEMONSTRATIONS
0938-0647 EVALUATION OF THE MEDICARE CASE MANAGEMENT DEMONSTRATION
0938-0646 OSCAR USERS QUESTIONNAIRE
0938-0644 Intake and Assessment Survey Package for the Community Nursing Organization Demonstration
0938-0642 STATE SURVEY AGENCY BUDGET/EXPENDITURE REPORT, STATE AGENCY CERTIFICATION WORKLOAD REPORT
0938-0641 GRANTEE DATA COLLECTION INSTRUMENT, ICA -- SECTION 4360
0938-0640 Medigap Complaint Data Base -- 42 CFR Section 403
0938-0637 PRENATAL SERVICES AND ASSISTANCE SCREENING QUESTIONNAIRE
0938-0636 SURVEYOR SURVEY FOR THE HOME HEALTH AGENCY ASSESSMENT EVALUATION PROJECT
0938-0635 CONTRACTOR FINANCIAL REPORTS -- HCFA-750B
0938-0634 CONTRACTOR FINANCIAL REPORTS -- HCFA-750A
0938-0632 STATUS OF ACCOUNTS RECEIVABLE -- HCFA-751B
0938-0630 STATUS OF ACOUNTS RECEIVABLE
0938-0629 MONITORING AND EVALUATION OF THE MEDICARE CATARACT SURGERY ALTERNATE PAYMENT DEMONSTRATION
0938-0628 STUDY OF MEDICAID UTILIZATION MANAGEMENT INITIATIVES
0938-0627 Video Display Terminal (VDT) Operators' Eye Care Program
0938-0626 Electronic Funds Transfer Authorization Agreement (CMS-588)
0938-0625 EVALUATION OF MARYLAND ACCESS TO CARE PROGRAM
0938-0624 Hospital Provider of Extended Care Services (Swing-Beds) in the Medicare and Medicaid Programs, 42 CFR 447.280 and 482.66
0938-0623 LONG TERM CARE PROGRAM AND MARKET CHARACTERISTICS STUDY
0938-0622 EVALUATION OF MEDICAID EXTENSION DEMONSTRATION
0938-0621 MEDICAID CAPITATED MANAGED CARE PROGRAM FOR SSI DISABLED
0938-0620 A STUDY OF MEDICARE PATIENTS WITH VERY LONG HOME HEALTH EPISODES -- TASK 3.1, HOME CARE QUALITY STUDIES -- HCFA CONTRACT NO. 500-89-0056
0938-0619 MEDICARE CURRENT BENEFICIARY SURVEY, ROUND 5 OMB SUPPLEMENT
0938-0618 Limitations on Provider Related Donations and Health Care Related Taxes; Medicaid and Supporting Regulations in 42 CFR 433.68 and 433.74 (CMS-R-148)
0938-0617 OUTPATIENT RESOURCE COSTING STUDY (18-C-901-23/3-01), DATA COLLECTION OF PROVIDERS OF OUTPATIENT SERVICES
0938-0616 CERTIFICATION RECOMMENDATION, CLIA LABORATORY
0938-0615 MEDICARE PHYSICIAN SURVEY FORM
0938-0613 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN THE REGULATION FOR HOME AND COMMUNITY-BASED SERVICES WAIVER FOR INDIVIDUALS AGE 65 OR OLDER
0938-0612 (CMS-R-26) Clinical Laboratory Improvement Amendments (CLIA) and Supporting Regulations
0938-0611 SCREENING MAMMOGRAPHY SERVICES DATA REPORT
0938-0610 (CMS-R-10) Advanced Directives (Medicare and Medicard)
0938-0609 MEDICARE INTERMEDIARY PART A AND PART B APPEALS REPORT
0938-0608 MEDICARE COVERAGE OF SCREENING MAMMOGRAPHY
0938-0607 CLINICAL LABORATORY IMPROVEMENT AMENDMENTS OF 1988, FEE COLLECTION -- 42 CFR SECTIONS 493.614, 493.633, AND 493.634
0938-0606 INTAKE AND FOLLOW-UP SURVEY OF MEDICARE BENEFICIARIES IN STAFF-ASSISTED HOME DIALYSIS DEMONSTRATION
0938-0605 PHYSICIAN PAYMENT DIFFERENTIALS IN GROUP PRACTICES SURVEY
0938-0604 State Survey Agency List of Positions and Schedule of Equipment Purchases
0938-0603 ATTENDING PHYSISIANS PARENTERAL/ENTERAL NUTRITION CERTIFICATION OF MEDICAL NECESSITY
0938-0602 EVALUATION OF THE OBRA 1967 MEDICARE PAYMENT FOR THERAPEUTIC SHOES BENEFICIARY SURVEY
0938-0601 PRECLEARANCE: INFORMATION COLLECTION FOR COMMUNITY NURSING ORGANIZATION DEMONSTRATION
0938-0600 Medicare Credit Balance Reporting Requirements and Supporting Regulations in 42 CFR 405.371, 405.378, and 413.20
0938-0599 CLIA Budget Workload Reports and Supporting Regulations (CMS-102, CMS-105)
0938-0597 TASK 4: HOME CARE WORKER SUPPLY AND HOME CARE QUALITY STUDIES
0938-0595 MEDICAID PROVIDERS TAXES AND DONATIONS PROGRAMS APPLICATION
0938-0594 MEDICARE SUPPLIER NUMBER APPLICATION
0938-0593 DISCHARGE AND FOLLOW-UP PATIENT INTERVIEWS (EVALUATION OF THE HOME HEALTH PROSPECTIVE PAYMENT DEMONSTRATION)
0938-0592 TASK 3.2 ACCESS TO AND ADEQUACY OF PARAPROFESSIONAL HOME CARE - HOME CARE QUALITY STUDIES
0938-0591 COST REPORT FORMAT FOR PEER REVIEW ORGANIZATIONS
0938-0590 HOME CARE AGENCY SCREENING INSTRUMENT AND FOLLOW-UP TELEPHONE INTERVIEW
0938-0588 A POLICY STUDY OF THE COST-EFFECTIVENESS OF INSTITUTIONAL SUBACUTE CARE ALTERNATIVES AND SERVICES
0938-0587 EVALUATION OF THE HOME HEALTH PROSPECTIVE PAYMENT DEMONSTRATION
0938-0586 PHYSICIAN FINANCIAL INTEREST IN CLINICAL LABORATORIES SURVEY FORM
0938-0585 APPLICATION TO PROVIDE COMMUNITY SUPPORTED LIVING ARRANGEMENTS (CSLA) SERVICES
0938-0583 Survey Team Composition and Workload Report
0938-0582 Medicaid Drug Rebate Program (MDRP): Quarterly State Invoice (CMS-R-144) and State Agency Contact Form (CMS-368)
0938-0581 (CMS-116) Clinical Laboratory Improvement Amendments Application Form 42 CFR 493.1-.2001
0938-0580 Criteria for Medicare Coverage of Liver Transplants
0938-0579 Business Proposal Forms For Quality Improvement Organizations (QIOs) (CMS-718-721)
0938-0578 Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367)
0938-0576 PRECLEARANCE - PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) EVALUATION
0938-0575 Medicare Physician Fee Schedule Geographic Practice Expense Index (GPCI)
0938-0574 END STAGE RENAL DISEASE (ESRD) MEDICAL CASE REVIEW
0938-0573 Medicare Geographic Classification Review Board Procedures and Criteria and Supporting Regulations in 42 CFR, Section 412.256
0938-0572 TERMINATION OF ENROLLMENT REGULATION -- BPD-306
0938-0571 ESTABLISHING PROCEDURES FOR TRANSMITTING INFORMATION BETWEEN MEDICARE CARRIERS AND MEDICARE SUPPLEMENTAL INSURERS
0938-0570 PATIENT INTAKE DATA FORM FOR THE NATIONAL HOME HEALTH AGENCY PROSPECTIVE PAYMENT DEMONSTRATION
0938-0569 AGENCY CHARACTERISTICS FORM FOR THE NATIONAL HOME HEALTH AGENCY PROSPECTIVE PAYMENT DEMONSTRATION
0938-0568 Medicare Current Beneficiary Survey (MCBS) (CMS-P-0015A)
0938-0567 Request for Hearing for Part B Medicare by an Administrative Law Judge and Supporting Regulations in 42 CFR, 498 Subpart D and E
0938-0566 Advance Beneficiary Notice of Noncoverage (ABN) and Supporting Regulations in 42 CFR 411.404 and 411.408 (CMS-R-131)
0938-0565 IRS/SSA/CMS Data Match and Supporting Regulations in 42 CFR Sections 411.20-411.206
0938-0564 Proper Claim Not Filed and Supporting Regulation Contained in 42 CFR 411.32(c)
0938-0563 STATE SURVEY AGENCY BUDGET REQUEST - LONG-TERM CARE FACILITY WORKLOAD
0938-0562 STATE SURVEY AGENCY QUARTERLY EXPENDITURE REPORT - LONG-TERM FACILITY WORKLOAD
0938-0561 PRECLEARANCE: IMPLEMENTATION AND EVALUATION OF THE HOME HEALTH PROSPECTIVE PAYMENT DEMONSTRATION
0938-0560 UNIFORM COST REPORT DEMONSTRATION--VALIDATION QUESTIONNAIRE
0938-0559 HOSPITAL AND HOSPITAL HEALTH CARE COMPLEX COST REPORT, FORM HCFA-2552-DEMO
0938-0558 INFORMATION COLLECTION REQUIREMENTS AT 42 CFR 411.54(C)(1) ITEMIZED STATEMENT OF HOSPITAL CHARGES
0938-0557 TAX EQUITY AND FISCAL RESPONSIBILITY ACT (TEFRA) HMO AND CMP PROGRAM EVALUATION BENEFICIARY SURVEY
0938-0556 INFORMATION COLLECTION REQUIREMENTS IN BPD-311-F, REVALUATION OF ASSETS
0938-0555 INFORMATION COLLECTION REQUIREMENTS IN BQC-64-F, STATE PLAN REQUIREMENTS AND OTHER PROVISIONS RELATING TO THIRD-PARTY LIABILITY (TPL) PROGRAMS
0938-0554 INFORMATION COLLECTION REQUIREMENTS FOR REQUESTING COST AVOIDANCE WAIVERS AS PROVIDED FOR IN BQC-64
0938-0553 INFORMATION COLLECTION REQUIREMENTS FOR THE THIRD-PARTY LIABILITY (TPL) ACTION PLAN AS PROVIDED FOR IN BQC-64
0938-0552 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-483, SECTION 403.408 DEMONSTRATION COST REPORT
0938-0550 PRECLEARANCE: HOME CARE QUALITY STUDIES
0938-0549 MEDICARE: SUPPORTING STATEMENT FOR REQUEST FOR MEDICAL REVIEW INFORMATION FOR PART B OUTPATIENT BILLS
0938-0548 MEDICARE - HMO REPORTING FORMS
0938-0547 MEDICARE - PILOT STUDY - OUTCOMES MANAGEMENT - HMOS
0938-0546 MEDICARE INFLUENZA VACCINE DEMONSTRATION
0938-0544 Survey Report Form Clinical Laboratory Improvement Amendments (CLIA) and supporting regulations (CMS-1557)
0938-0543 PILOT TEST OF A HOME HEALTH AGENCY FUNCTIONAL ASSESSMENT INSTRUMENT
0938-0542 MEDICARE - INFORMATION COLLECTION REQUIREMENTS FOR HOME HEALTH AGENCIES & HOSPICES AT 42 CFR 421.117(E) AND (F) AND SECTION 140 OF THE HHA & HOSPICE MANUALS, ETC.
0938-0538 COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY INFORMATION COLLECTION REQUIREMENTS -- 42 CFR 485.56, 485.58, 485.60, 485.64, 485.66, AND 405.262
0938-0537 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-408-F PAYMENT FOR KIDNEYS SENT TO FOREIGN COUNTRIES OR TRANSPLANTED IN PATIENTS OTHER THAN MEDICARE BENEFICIARIES
0938-0535 REFUNDING OF FEDERAL SHARE OF OVERPAYMENTS MADE TO MEDICAID PROVIDERS
0938-0534 Attending Physician's Certification of Medical Necessity for Home Oxygen Therapy and Supporting Regulations 42 CFR 410.38 and 42 CFR 424.5
0938-0533 MEDICARE THERAPEUTIC SHOE DEMONSTRATION PROGRAM CERTIFICATION AND PRESCRIPTION FORM
0938-0532 MEDICARE ALZHEIMER'S DISEASE DEMONSTRATION
0938-0531 PRO Reporting Forms
0938-0528 SECTION 4005(D) OBRA: EXPANSION OF SWING BED PROGRAM
0938-0527 MEDICARE, MEDICAID, AND CLINICAL LABORATORIES IMPROVEMENT ACT (CLIA) PATIENT CONFIDENTIALITY RULES, 42 CFR 74.53(B) (C), 405.1316(F)(2)(3) AND 441.16(A)(B) AND (C)
0938-0526 Quality Improvement (formerly Peer Review) Organization Contracts: Solicitation of Statement of Interest from In-State Organizations, General Notice and Supporting...
0938-0525 SUPPLEMENTAL SURVEY MECHANISM
0938-0524 HMO/CMP DISENROLLMENT SURVEY FORM
0938-0523 Information Collection Requirements Contained in 42 CFR 447.253
0938-0522 SEC. 1867 OF THE SOCIAL SECURITY ACT: EXAMINATION & TREATMT. FOR EMERGENCY MEDICAL CONDITIONS & WOMEN IN ACTIVE LABOR & 42 CFR 489.24 ESSENTIALS OF PROVIDER AGREEMENTS, ETC.
0938-0521 MEDICAID - INFORMATION COLLECTION REQUIREMENTS IN HSQ-127-F 42 CFR SECTIONS 442.114(A), 441.115(A) AND 442.116(A)(C) AND (D)
0938-0520 MEDICARE - HMO REPORTING FORMS
0938-0519 Medicare Home Health Quality Assurance Demonstration -- 42 CFR 484
0938-0518 BENEFICIARY INCENTIVES TO PARTICIPATE IN ALTERNATIVE HEALTH PLANS
0938-0517 DATA COLLECTION TO ESTABLISH A FEE SCHEDULE FOR THE SERVICES OF CRNAS
0938-0516 PRE CLEARANCE FOR: A988 PHYSICIANS PRACTICE COSTS AND INCOMES SURVEY
0938-0515 MEDICARE - EVALUATION OF OPA MARKETING EDUCATIONAL PROMOTION SURVEY QUESTIONNAIRE
0938-0514 PILOT TEST - HOME HEALTH AGENCY SURVEY FORMS
0938-0513 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-356-F "LIMITS ON PAYMENTS FOR DRUGS"
0938-0512 Organ Procurement Organization's Health Insurance Benefits Agreement and Supporting Regulations 42 CFR 486.301-486.348 (CMS-576A)
0938-0511 Skilled Nursing Facility Prospective Payment System Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24
0938-0510 MEDICARE - INFORMATION COLLECTION REQUIREMENTS IN SOM SECTION 2280 AND ROM - SECTION - 5223 DIALYSIS AT HOME PROGRAM
0938-0509 THE HOME AND COMMUNITY-BASED SERVICES WAIVERS MANUAL INSTRUCTIONS
0938-0508 APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT PARTICIPATION IN MEDICARE, INFORMATION COLLECTION REQUIREMENTS -- 42 CFR 498
0938-0507 Medicare Managed Care Disenrollment Form
0938-0506 Ambulatory Surgical Centers Conditions for Coverage and Supporting Regulations -- 42 CFR 416.43 and 416.47
0938-0505 MISCELLANEOUS CONFORMING AMENDMENTS
0938-0504 INFORMATION COLLECTION REQUIREMENTS IN BPO-41P, ADJUSTMENT OF FEDERAL SHARE FOR UNCASHED OR CANCELLED CHECKS, 45 CFR SECTIONS 201.5 (A)(3), 201.67 (C)(2) & 201.67(D)(2)
0938-0503 PRECLEARANCE FOR: EVALUATION OF TEFRA HMO AND CMP PROGRAM (PRECLEARANCE NO. 008)
0938-0502 Medicaid - Determining Third Party Liability (TPL) State Plan Preprint and Supporting Regulation in 42 CFR 433.138 (CMS-R-107)
0938-0501 Medicare Qualification Statement for Federal Employees and Supporting Regulations in 42 CFR 406.15
0938-0500 EVALUATION OF THE MEDICARE COMPETITION DEMONSTRATIONS
0938-0499 RECORDKEEPING REQUIREMENTS CONTAINED IN PROVIDER REIMBURSEMENT MANUAL -- SECTIONS 2198 AND 2746
0938-0497 "MEDICAID" INFORMATION COLLECTION REQUIREMENTS IN BPO-47-FN, MMIS REQUIREMENTS FOR PHYSICIAN AND SUPPLIER SERVICES
0938-0496 "MEDICARE" NEW YORK BILLING FORM
0938-0492 MEDICARE ESRD OUTCOME SURVEY REPORT FORM
0938-0491 MEDICARE - PRO REPORTING FORMS
0938-0490 Criteria for Medicare Coverage of Heart Transplants
0938-0489 Information Collection Requirements for Sole Community Home Health Agencies -- 42 CFR 424.22
0938-0488 MEDICAID - INFORMATION COLLECTION REQUIREMENTS IN ALTERNATIVE SANCTIONS FOR LONG TERM CARE FACILITIES, 42 CFR 442.118(B)
0938-0487 Systems Performance Review (SPR)
0938-0486 Regulations for Hearing for Part A Medicare by an Administrative Law Judge and Supporting Regulations in 42 CFR, 498 Subpart D and E
0938-0485 MEDICARE/MEDICAID HOSPITAL SWING-BED SURVEY REPORT FORM
0938-0484 Emergency and Foreign Hospital Services Beneficiary Statement in Canadian/Mexican Travel Claims and Supporting Regulations in 42 CFR, Section 424.123
0938-0483 INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED PROTOTYPE SURVEY REPORT FORM
0938-0482 MEDICARE - ELECTION TO RECALCULATE MEDICARE REIMBURSEMENT BASED ON 42 CFR 405.457
0938-0481 Sterilization Regulations and Consent Form
0938-0479 TITLE XIX SUPERIOR UTILIZATION REVIEW (UR) SYSTEM WAIVER REQUEST INFORMATION COLLECTION REQUIREMENT-SECTIONS 9320-9330 OF STATE MEDICAID MANUAL
0938-0478 THE LONG TERM CARE REQUEST FOR CERTIFICATION
0938-0477 Payment Adjustment for Sole Community Hospitals and Supporting Regs. in 42 CFR 412.92
0938-0476 HOSPICE CORE SERVICE: NURSING (HOSPICE MANUAL)
0938-0475 Hospice Core Service: Nursing Information Collection
0938-0473 INFORMATION COLLECTION REQUIREMENTS IN BERC-240-F, RECOGNITION OF STATE REIMBURSEMENT CONTROL SYSTEM
0938-0472 Requirement to Disclose HMO Financial Information to Members and Supporting Regulations in 42 CFR 417.124
0938-0471 42 CFR PART 110 - (NPRM) HEALTH MAINTENANCE ORGANIZATIONS
0938-0470 The Application for Federal Qualification (CMS 901A) Regulations in 42 CFR Section 417.140 and the Medicare Health Care Prepayment Plan Application (CMS 901D) in 42 CFR 417.800.
0938-0469 The Fiscal Soundness Reporting Requirements
0938-0467 Income and Eligibility Verification System Reporting and Supporting Regs. (CMS-R-74)
0938-0465 Limitation on Liability and Information Collection Requirements Referenced in 42 CFR 411.404, 411.406, and 411.408
0938-0464 MEDICAID PROGRAM CHARACTERISTICS QUESTIONNAIRE
0938-0463 Skilled Nursing Facility and Skilled Nursing Facility Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, and 413.106
0938-0461 MEDICARE - INFORMATION COLLECTION REQUIREMENTS IN HCFA-PUB. 14-3 CARRIER MANUAL SECTIONS 2070.2, 3060.2.D., 4110.2 AND 4110.4 - PHYSICIAN/SUPPLIER BACKGROUND INFORMATION
0938-0460 INFORMATION COLLECTION REQUIREMENT IN HCFA PUBLICATION 14-3 SECTION 2120.1-2125 AND SECTION 4115 OF THE CARRIERS MANUAL
0938-0459 INFORMATION COLLECTION REQUIREMENTS IN BPO-500-F, THIRD-PARTY LIABILITY FOR MEDICAL ASSISTANCE, FFP RATES FOR SKILLED PROFESSIONAL MEDICAL PERSONNEL AND SUPPORTING STAFF
0938-0458 UNIFORM HOSPITAL BILL (HCFA-1450) AND RELATED ELECTRONIC MEDIA CLAIM FORMAT - MEDICAID SYSTEM REQUIREMENTS
0938-0457 INDIRECT COST OF MEDICAL EDUCATION - PROVIDER REIMBURSEMENT MANUAL
0938-0456 Indirect Medical Education (IME) and Supporting Regulations 42 CFR 412.105 (CMS-R-64)
0938-0454 Physician Certifications/Recertifications in Skilled Nursing Facilities Manual Instructions and Supporting Regs.
0938-0452 MEDICARE, CARRIER APPEAL REPORT
0938-0451 JCAH HOSPICE MAIL SURVEY QUESTIONNAIRE
0938-0450 EVALUATION OF SOCIAL/HEALTH MAINTENANCE ORGANIZATION (S/HMO) DEMONSTRATION
0938-0449 Home & Community Based Waiver Requests and Supporting Regulations; 42 CFR 440.180 and 441.300 - 441.310 (CMS-8003)
0938-0448 End Stage Renal Disease Death Notification (CMS-2746)
0938-0447 End Stage Renal Disease Medical Information System ESRD Facility Survey and Supporting Regulations in 42 CFR 405.2133 (CMS-2744)
0938-0446 RECIPIENT, USE AND EXPENDITURES FOR MEDICAID ENROLLEES COVERED UNDER SECTION 1619(A) AND (B) OF THE SOCIAL SECURITY ACT
0938-0445 (CMS-R-71) Quality Improvement Organization (QIO) Assumption of Responsibilities and Supporting Regulations
0938-0444 (CMS-R-65) Final Peer Review Organizations Sanction and Supporting Regulations
0938-0443 (CMS-R-72) Information Collection Requirements in 42 CFR Sections 478.18, 478.34, 478.36, and 478.42 QIO Reconsiderations and Appeals
0938-0442 MEDICAID - MMIS: CONDITION OF APPROVAL AND REAPPROVAL AND PROCEDURES FOR REDUCTION OF FFP, 42 CFR 433.112, 433.116, AND 433.117
0938-0441 PROVIDER OVERPAYMENT REPORT
0938-0440 PRO SEMIANNUAL RESOURCES ALLOCATION REPORT
0938-0439 Medicare Physician/Supplier Overpayments
0938-0438 INFORMATION COLLECTION REQUIREMENTS CONCERNING CLAIMS PROCESSING ASSESSMENT SYSTEM (CPAS) -- HCFA-R-91, 331, 505, AND HCFA-R-83
0938-0437 COURT ORDERED REGULATIONS REGARDING PROSPECTIVE PAYMENT AMOUNTS AND ADMINISTRATIVE REVIEW
0938-0436 Pacemaker Related Data
0938-0434 AMBULATORY SURGICAL CENTER PAYMENT RATE SURVEY
0938-0433 INTERMEDIARY'S REQUEST TO HOSPITALS FOR MEDICAL INFORMATION ON OUTPATIENT CLAIMS
0938-0432 NATURE, PROCESS, AND MODES OF HOSPICE CARE DELIVERY HOSPICE SURVEY PROFILE AND HOSPICE ASSESSMENT AND SURVEY
0938-0431 INFORMATION COLLECTION REQUIREMENTS IN BOC-18-F, CLAIMS PROCESSING ASSESSMENT SYSTEM (CPAS)
0938-0430 EVALUATION OF THE MEDICAID COMPETITION (CAPITATION) DEMONSTRATIONS
0938-0429 Imposition of Cost Sharing Charges Under Medicaid and Supporting Regulations contained in 42 CFR Section 447.53
0938-0428 STATE MEDICAID MANUAL, PART 3, ON ASSIGNMENT OF RIGHTS
0938-0427 PRECLEARANCE FOR: COMPETITIVE BIDDING FOR DURABLE MEDICAL EQUIPMENT DEMONSTRATION (NO. 003)
0938-0426 (CMS-R-70) HSQ-110 Acquisition, Protection, and Disclosure of Quality Improvement Organization (QIO) Information and Supporting Regulations
0938-0425 PRECLEARANCE FOR: PROSPECTIVE PAYMENT AND ANALYTICAL SUPPORT STUDIES
0938-0423 PRECLEARANCE: EVALUATION OF THE CLINICAL LABORATORY SERVICES DEMONSTRATION
0938-0422 COVERAGE OF OXYGEN FOR USE IN A PATIENT'S HOME - BERC-024 FNC AND MANUAL INSTRUCTIONS, "MEDICARE"
0938-0421 PRECLEARANCE: DESIGN AND EVALUATION OF THE HOME HEALTH AGENCY PROSPECTIVE PAYMENT DEMONSTRATION
0938-0419 ADMISSION AND QUALITY OBJECTIVE PROGRESS REPORTS
0938-0418 MEDICARE - QUARTERLY ACUTE CARE GENERAL HOSPITAL REPORT SUMMARY AND THE QUARTERLY SPECIALTY HOSPITAL REVIEW REPORTING SUMMARY
0938-0414 MEDICAID STATE AGENCY THIRD PARTY LIABILITY INVENTORY FORM
0938-0413 REPORT OF PRO REVIEW ACTIVITY
0938-0408 Methodology for Estimating Waiver Costs of HCFA Demonstration Projects
0938-0407 ELECTRONIC MEDIA CLAIM (EMC)/HARD COPY (HC) STUDY
0938-0406 INFORMATION COLLECTION REQUIREMENTS IN BERC-247-F, PAYMENTS TO HEALTH MAINTENANCE ORGANIZATIONS AND COMPETITIVE MEDICAL PLANS, R-29
0938-0405 RECONSIDERATION DETERMINATION AND SANCTION REPORT
0938-0404 SKILLED NURSING FACILITY SURVEY FORM
0938-0402 STATEMENT OF CUMULATIVE EXPENDITURES FOR DEMONSTRATION PROJECTS
0938-0400 MEDICARE/MEDICAID -- SKILLED NURSING FACILITIES AND NURSING FACILITIES SURVEY REPORT FORM AND WORKSHEETS
0938-0399 MEDICARE PROGRAM CARRIER PERFORMANCE REPORT
0938-0397 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN 42 CFR, SECTIONS 447.413 AND 447.415 (BPO-07-F)
0938-0396 PRECLEARANCE: NONCERTIFIED HOSPICE COST ANALYSIS
0938-0395 HEALTH FACILITY LICENSURE AND CERTIFICATION DIRECTORS SURVEY QUESTIONNAIRE
0938-0394 DIALYSIS PATIENT QUESTIONNAIRE
0938-0393 HOME HEALTH AGENCY COST REPORT, SUPPLEMENT K
0938-0392 HOSPICE COST REPORT AND DATA FORM
0938-0391 Statement of Deficiencies and Plan of Correction (CMS-2567)
0938-0390 Post-Certification Revisit Report
0938-0389 SURVEY OF SELF INSURED PLANS
0938-0387 SCHEDULE OF NET HOURS AVAILABLE
0938-0386 (CMS-R-52) End State Renal Disease (ESRD) Conditions for Coverage and Supporting Regulations
0938-0385 PRECLEARANCE: EVALUATION OF SOCIAL/HEALTH MAINTENANCE ORGANIZATION (S/HMO) DEMONSTRATION
0938-0384 "MEDICARE" QUARTERLY PERIODIC INTERIM PAYMENT REPORT
0938-0383 Medicare: Information on Provider Refunds and Supporting Regulations in 42 CFR 489.40-41
0938-0382 Medicare/Medicaid Hospital Surveyor's Worksheet and Supporting Regulations at 42.C.F.R. 488.26 and 442.30
0938-0381 REPAYMENT REQUEST DOCUMENTS - HOSPITAL, SNF, HHA
0938-0380 Hospital Request for Certification in the Medicare/Medicaid Program
0938-0379 Hospice Survey and Deficiencies Report Form (CMS-643)
0938-0378 (CMS-724) MEDICARE/MEDICAID PSYCHIATRIC HOSPITAL SURVEY DATA AND SUPPORTING REGULATIONS
0938-0377 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-297-FC & RELATED INSTRUCTIONS IMPLEMENTING THE U.S. DISTRICT COURT'S DECISION IN LYNCH V. RANK
0938-0376 MEDICARE HISTOCOMPATIBILITY TESTING LABORATORIES SURVEY REPORT FORM
0938-0373 Medicare Participating Physician or Supplier Agreement
0938-0372 ESRD Beneficiary Selection and Supporting Regulations Contained in 42 CFR 414.330
0938-0371 INTERMEDIARY BENEFIT PAYMENT REPORT
0938-0370 CONDITIONS OF PARTICIPATION FOR LONG-TERM CARE FACILITIES "MEDICAID" AND "MEDICARE"
0938-0368 INFORMATION COLLECTION REQUIREMENTS IN 42 CFR PART 405.1315, 1316, AND 1317 CONDITIONS OF PARTICIPATION FOR LABORATORIES
0938-0366 ITERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED, CONDITIONS OF PARTICIPATION, ICF/MR
0938-0365 (CMS-R-39) Home Health Medicare Conditions of Participation (CoP) and Supporting Regulations
0938-0364 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN 405.1121, 405.1123, 405.1124, 405.1125, 405.1126, 405.1127, 405.1128, 405.1136 & 405.1137-CONDIT. OF PARTIC. SKILLED NURSING FCLS.
0938-0361 CONTRACTOR DRAWS ON LETTER OF CREDIT AND MONTHLY CONTRACTOR FINANCIAL REPORT
0938-0360 (CMS-3427) End Stage Renal Disease Application and Survey and Certification Report Form and Supporting Regulations
0938-0359 Medical Records Review Under PPS and Supporting Regulations at 42 CFR 412.40-412.52
0938-0358 (CMS-437) Psychiatric Unit Criteria Work Sheet and Supporting Regulations
0938-0357 Home Health Services Under Hospital Insurance, Manual Instructions and Supporting Regulations in 42 CFR 409.40 - 50, 410.36, 410.170, 411.4-.15, 421.100, 424.22, 484.18 and 489.21
0938-0356 HCFA FORMS AND MANUAL ORDER
0938-0355 Home Health Agency Survey and Deficiencies Report and Supporting Regulations (CMS-1572)
0938-0354 Annual Early and Periodic Screening, Diagnostic and Treatment Services (EPSDT) Participation Report (CMS-416)
0938-0351 INFORMATION COLLECTED FROM FISCAL INTERMEDIARIES AND CARRIERS - FINANCIAL COLLECTIONS CATEGORY
0938-0350 MEDICARE CONTRACTOR ADMINISTRATIVE BUDGET AND COST REPORTING SYSTEM FORMS
0938-0349 SURVEY OF SEC. 2176 HOME & COMMUNITY BASED MEDICAID WAIVER PROGRAMS (SURVEY FOR THE DEVELOPMENTALLY DISABLED & CHRONICALLY MENTALLY ILL) - SURVEY OF THE IE OR OTHER PDP
0938-0347 HOSPITAL WAGE INDEX SURVEY
0938-0346 MEDICARE/MEDICAID HEALTH CARE FACILITY SURVEY AND CERTIFICATION FORMS
0938-0345 Transformed - Medicaid Statistical Information System (T-MSIS) (CMS-R-284)
0938-0344 MEDICAID ELIGIBILITY QUALITY CONTROL - INFORMATION COLLECTION REQUIREMENTS IN 42 CFR 431.804(D)(3) AND (4)
0938-0342 1984 LONG-TERM CARE SURVEY
0938-0341 REPORT OF MEDICAL REVIEW ACTIVITY
0938-0340 MEDICAID QUALITY CONTROL (MQC) DISPOSITION LIST
0938-0339 42 CFR 433.113, FFP FOR OPERATION OF MECHANIZED CLAIMS PROCESSING AND INFORMATION RETRIEVAL SYSTEMS
0938-0338 (CMS-R-43) Medicare and Medicaid Programs: Conditions of Participation for Portable X-ray Suppliers
0938-0337 INFORMATION COLLECTION REQUIREMENTS IN 42 CFR 405.460 EXCEPTIONS TO COST LIMITS
0938-0336 Conditions of Participation for Rehabilitation Agencies and Conditions for Coverage for Physical Therapists in Independent Practice
0938-0334 (CMS-R-38) Medicare and Medicaid Programs: Conditions for Certification for Rural Health Clinics and Conditions for Coverage for FQHCs in 42 CFR 491
0938-0328 Hospital Conditions of Participation (COP) and Supporting Regulations (CMS-R-48)
0938-0326 INFORMATION COLLECTION REQUIREMENTS IN 42 CFR PART 434, SUBPARTS A THRU E, MEDICAID CONTRACTS WITH HEALTH MAINTENANCE ORGANIZATIONS (HMOS) & PREPAID HEALTH PLANS
0938-0325 STATISTICAL REPORT ON MEDICAL CARE: RECIPIENTS, PAYMENTS AND SERVICES
0938-0313 (CMS-417) Hospice Request for Certification and Supporting Regulations
0938-0312 RECALCULATION OF CASE-MIX INDEX BASED ON TOTAL MEDICARE DISCHARGES
0938-0310 MEDICAID ELIGIBILITY QUALITY CONTROL(MEQC) STATISTICAL TABLES
0938-0309 INFORMATION COLLECTION REQUIREMENTS IN REGULATIONS SECTION 405.476(B) SOLE COMMUNITY HOSPITAL EXCEPTION (PROSPECTIVE PAYMENT, BERC-263)
0938-0308 INFORMATION COLLECTION REQUIREMENTS IN PROSPECTIVE PAYMENT REGULATIONS (B&CR-263) SECTIONS 405.476(B), 405-476(D), 405.1042(C), 405.1627, & 405.1629
0938-0306 INFORMATION COLLECTION REQUIREMENTS IN REG. SEC. 405.1627 & 405.1629, PHYSICIAN CERTIFICATION & RECERTIFICATION (PROSPECTIVE PAYMENT REG, BERC-263)
0938-0305 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN REGULATION SECTION 405.1042(C), HOSPITAL UTILIZATION REVIEW PLAN (PROSPECTIVE PAYMENT, BERC-263)
0938-0304 INFORMATION COLLECTION REQUIREMENTS IN REGULATION 489.23(B) AND (C) (WAIVER OF REQUIREMENTS TO BILL NON-PHYSICIAN SERVICES ON PART A-PROSPECTIVE PAYMENT, BERC-263)
0938-0302 Information Collection Requirements in the Hospice Care Regulation, 42CFR 418.22, 418.24, 418.28, 418.56, 418.58, 418.70, 418.83, 418.96, and 418.100
0938-0301 Medicare Provider Cost Report Reimbursement Questionnaire and Supporting Regulations in 42 CFR 413.20, 413.24, and 415.60 (CMS-339)
0938-0300 Quality Control of Negative Case Actions (NCA)
0938-0298 PROFESSIONAL STANDARDS REVIEW ORGANIZATION ROUTINE FEDERAL REPORTING REQUIREMENTS
0938-0296 Medicare ESRD Exceptions
0938-0295 FREEDOM OF CHOICE: WAIVERS OF AND EXCEPTIONS TO STATE PLAN REQUIREMENTS, 42 CFR 431.54(F)(3) AND 431.55(B)(2)
0938-0294 PRECLEARANCE: EVALUATION OF THE MEDICAID COMPETITION DEMONSTRATION
0938-0291 EARLY PERIODIC SCREENING DIAGNOSTIC AND TREATMENT (EPSDT) REPORT
0938-0290 MODIFICATION TO NATIONAL (RURAL) SWING-BED EVALUATION
0938-0289 MEDICARE EVALUATION OF THE MEDICARE COMPETITION SURVEY QUESTIONNAIRE
0938-0288 TRANSMITTAL OF SUPPLEMENTARY INFORMATION FOR DETERMINATION OF THE TARGET AMOUNT UNDER THE MEDICARE PROSPECTIVE PAYMENT SYSTEM
0938-0287 Withholding Medicare Payments to Recover Medicaid Overpayments and Supporting Regulations in 42 CFR 447.31 (CMS-R-21)
0938-0286 EVALUATION OF MEDICARE AND MEDICAID ALCOHOLISM SERVICES DEMONSTRATION
0938-0285 PAYMENT FOR PHYSICIANS' SERVICES FURNISHED IN HOSPITALS, SNFS, AND CORFS
0938-0284 1988 PHYSICIANS' PRACTICE COST AND INCOME SURVEY
0938-0282 Quarterly Showing Validation Survey
0938-0281 EVALUATION OF ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
0938-0279 Medicare Uniform Institutional Provider Bill
0938-0278 MEDICARE HHA PROSPECTIVE PAYMENT DEMONSTRATION
0938-0275 PSRO ROUTINE FEDERAL REPORTING REQUIREMENTS, HCFA 111, 121-B 135, 153, SF 269
0938-0273 (CMS-381) Extension Locations of Medicare Approved Providers of Outpatient Physical Therapy and Speech-Language Pathology (OPT) Services
0938-0272 Annual Report on Home and Community-based Services Waivers (CMS-372(S))
0938-0271 STATEMENT OF REIMBURSABLE COST - ALCOHOLISM DEMONSTRATION
0938-0270 The Financial Statement of Debtor and Supporting Regulations in 42 CFR, Section 405.376 (CMS-379 )
0938-0269 Request for Accelerated Payments Supporting Regs in 42 CFR, section 412.116(f), 412.632(e), 413.64(g), 413.350(d) & 484.245
0938-0268 ANNUAL REPORT ON WAIVERS FOR HOME AND COMMUNITY BASED SERVICES
0938-0267 (CMS-359/360) Comprehensive Outpatient Rehabilitation Facility (CORF) Certification and Survey Forms
0938-0266 Ambulatory Surgical Center (ASC) Health Insurance Benefits Agreement Form, Request for Certification, Survey Report (CMS-377; CMS-370)
0938-0264 MEDICARE SUPPLEMENTAL POLICIES
0938-0263 MEDICARE EXCLUSION OF SERVICES REIMBURSABLE UNDER AUTOMOTIBLE, NO-FAULT OR LIABILITY INSURANCE
0938-0262 REPORT ON PROVIDER PARTICIPATION IN THE MEDICAID PROGRAM
0938-0259 BILLING FORM FOR THE ALCOHOLISM SERVICES COVERAGE DEMONSTRATION
0938-0258 Physical Therapist in Independent Practice Request for Certification in the Medicare Program
0938-0257 SURVEY OF RECENT OPTOMETRY GRADUATES TO DETERMINE PRACTICE PATTERNS
0938-0256 EVALUATION STUDY OF THE HMO CAPITATION DEMDEMONSTRATION
0938-0255 EVALUATION OF MUNICIPAL HEALTH SERVICES PROGRAM
0938-0254 PRECLEARANCE OF PROPOSED CONTRACT TO PROVIDE DIRECT REIMBURSEMENT OF CLINICAL SOCIAL WORKERS
0938-0253 MEDICARE - HOSPITAL PROVIDERS OF LONG-TERM CARE (SWING-BED PROVISION)
0938-0252 MEDICARE COMPETITION DEMONSTRATION PRECLEARANCE
0938-0251 Application for Enrollment in Medicare Part A, Internet Claim (iClaim) Application Screen, Modernized Claims System and Consolidated Claim (CMS-18F5)
0938-0249 SURVEY OF PRIVATE HEALTH INSURANCE
0938-0247 Medicaid Management Information System (MMIS)
0938-0246 Certification of Medicaid Eligibilty Quality Control (MEQC) Payment Error Rates and Supporting Regulations at 42 CFR.431.800 through 431.865
0938-0245 Request for Enrollment in Supplementary Medical Insurance and Supporting Regs in 42 CFR 407.10, 407.11 & 408.40 (CMS-4040)
0938-0244 MEDIGAP INDUSTRY SURVEY
0938-0243 CONTRACTORS' INFORMATION COLLECTION-POST PROCESSING OF CLAIMS DATA
0938-0242 Fire Safety Survey Report Forms (CMS-2786)
0938-0241 LONG TERM CARE DEMONSTRATION PROJECT OF NORTH SAN DIEGO COUNTY
0938-0240 UNIFORM BILLING FORM FOR THE STATE OF NEW YORK, FR. UBF-1, "MEDICARE"
0938-0239 DELIVERY OF MEDICAL & SOCIAL SERVICES TO THE HOMEBOUND ELDERLY, NEW YORK CITY -- BILLING FORMS
0938-0238 CONTRACTORS INFORMATION COLLECTION - ORGAN PROCUREMENT AGENCY AND HISTOCOMPATIBILITY LABORATORY FORMS
0938-0236 Renal Dialysis Facility Cost Report
0938-0235 FREESTANDING FEDERALLY-FUNDED HEALTH CENTER COST REPORT
0938-0234 MEDICARE - CLAIMS DEVELOPMENT DATA PROVIDED BY CHIROPRACTORS
0938-0233 CONTRACTORS INFORMATION COLLECTIONS--CLAIMS DEVELOPMENT PHYSICIANS AND OTHER HEALTH CARE PROVIDERS
0938-0232 CONTRACTORS' INFORMATION COLLECTIONS - CARRIERS' EXTERNAL AUDIT OF SERVICES PROVIDED TO BENEFICIARIES
0938-0231 CONTRACTORS' INFORMATION COLLECTION-- "STATE MEDICAID AGENCY VERIFICATION OF SERVICES RECEIVED"
0938-0230 END STAGE RENAL DISEASE BILLING SUPPLEMENT FORM
0938-0229 CONTRACTORS INFORMATION COLLECTIONS - SOLE COMMUNITY PROVIDER EXEMPTION REQUESTS
0938-0228 CONTRACTORS INFORMATION COLLECTIONS - INTERMEDIARIES COLLECTION OF DATA ON OWNERS COMPENSATION
0938-0227 REQUEST FOR MEDICAL REVIEW OF PART B INTERMEDIARY OUTPATIENT THERAPY CLAIMS
0938-0226 CONTRACTORS INFORMATION COLLECTIONS - "CLAIMS DEVELOPMENT HOME HEALTH AGENCIES"
0938-0225 CONTRACTORS' INFORMATION COLLECTION - "MACHINE READABLE CLAIMS"
0938-0224 Medicare: Intermediary Request to Hospitals for Medical Information on Inpatient Claims for Statutorily Excluded Services -- SSA 1862; 42 CFR 411.15; 60 FR 181
0938-0223 Medicare Intermediary Request to Skilled Nursing Facilities for Medical Information on Claims to be Processed
0938-0222 MEDICARE-CLAIMS DEVELOPMENT DATA FROM BENEFICIARIES AND/OR SUPPLIERS & PROVIDERS, INTERMEDIARY MANUAL SECTIONS 3114, 3647, 3763, 3766, CARRIER MANUAL SECTIONS 2105, 2125, ETC.
0938-0220 PRECLEARANCE--EVALUATION OF THREE DEMONSTRATIONS IN NURSING HOMES CERTIFICATION SURVEY AND INSPECTIONS OF CARE
0938-0219 CONTRACTORS' INFORMATION COLLECTIONS - ADMINISTRATIVE DATA, UNCONNECTED WITH INDIVIDUAL CLAIM
0938-0218 CONTRACTORS' INFORMATION COLLECTIONS - RECONSIDERATIONS/ APPEALS
0938-0217 CONTRACTORS' INFORMATION COLLECTIONS INTERIM PAYMENT ADJUSTMENT FORMS FOR HHAS
0938-0216 CONTRACTOR INFORMATION COLLECTION - PROVIDER PERMANENT REFERENCE FILE
0938-0215 CONTRACTORS' INFORMATION COLLECTIONS--PERIODIC AUDIT OF PROVIDER/SUPPLIER CLAIMS DATA
0938-0214 Medicare Secondary Payer Informaiton Collection and Supp. Regs. in 42 CFR 489.20, 411.25, 489.2
0938-0213 CONTRACTOR INFORMATION COLLECTION--CONTRACTOR PROGRAM INTEGRITY FORMS TO VERIFY SERVICES
0938-0212 CONTRACTORS' INFORMATION COLLECTION--AUDIT PROGRAMS
0938-0211 Installment Agreement on Beneficiary Refund of Overpayment, HCFA-Pub. 13-3 and HCFA-Pub. 14-3
0938-0210 FEDERAL RE-REVIEW PROCESS (MEDICAID ELIGIBILITY QUALITY CONTROL)
0938-0209 MEDICARE - RURAL HEALTH CLINICS-REQUESTS FOR MEDICAL INFORMATION HCFA-PUB. 13-3 INTERMEDIARY MANUAL SEC. 3640.14
0938-0208 CONTRACTORS INFORMATION ON COLLECTIONS-REGIONAL OFFICE PROGRAM VALIDATION REVIEWS OF PROVIDERS AND MEDICAID AGENCIES
0938-0207 CONTRACTORS' INFORMATION COLLECTIONS -- COMPREHENSIVE HEALTH CENTER FORMS
0938-0206 REQUEST TO ADJUST CUSTOMARY CHARGE SCREEN
0938-0205 QUESTIONNAIRE CONCERNING FORGED CHECK
0938-0204 CONTRACTORS INFORMATION COLLECTIONS-HCFA REGIONAL OFFICE PROGRAM INTEGRITY FORMS TO VERIFY SERVICES
0938-0203 "MEDICAID ELIGIBILITY QUALITY CONTROL," REGIONAL OFFICE COLLATERAL CONTACTS
0938-0202 Home Office Cost Statement and Supporting Regulations in 42 CFR 413.17 and 413.20 (CMS-287-21)
0938-0201 CONTRACTORS' INFORMATION COLLECTION -- EXTENDED REPAYMENT SCHEDULE
0938-0200 CONTRACTORS' INFORMATION COLLECTION SUPPLEMENTAL DESK REVIEW
0938-0199 ANCILLARY SERVICES UTILIZATION STUDY
0938-0198 EVALUATION OF NEW YORK'S LONG-TERM HOME HEALTH CARE PROGRAM
0938-0197 QUESTIONNAIRE ON MEDICAID STATE AGENCY FRAUD AND ABUSE CONTROL ACTIVITIES
0938-0196 MEDICARE MENTAL HEALTH DEMONSTRATION COST & STATISTICAL REPORT
0938-0193 Medicaid State Plan Base Plan Pages (CMS-179)
0938-0190 TELEPHONE SURVEYS OF MEDICARE PART B PROVIDERS AND BENEFICIARIES (TO EVALUATE PART B FIXED PRICE CONTRACTING)
0938-0189 NATIONAL HEART TRANSPLANT STUDY
0938-0188 329 REQUIREMENT FOR NARRATIVE NOTATION OF HOME HEALTH VISIT IN MEDICAL RECORDS
0938-0186 DIRECT DEALING LETTER NO. 301-BILLING FOR PHYSICAL THERAPY SERVICES
0938-0185 MEDICARE URBAN CLINICS DEMONSTRATION PRE-CLEARANCE ORDS 81-4-095
0938-0184 PRECLEARANCE: MEDIGAP HCFA-81-ORDS-32/AMG
0938-0181 SURVEY FOR THE NATIONAL HOSPITAL RATE-SETTING STUDY
0938-0180 MEDICARE MEDICARE INTERIM PAYMENT UPDATE REPORT
0938-0179 CONTRACTOR'S INFORMATION COLLECTION - PROVIDER BASED PHYSICIAN FORMS
0938-0178 CONTRACTORS INFORMATION COLLECTIONS - ADMISSIONS
0938-0177 HOSPICE STATEMENTS OF REIMBURSEMENTS
0938-0174 STUDY OF UNENTITLED ESRD POPULATION
0938-0173 MEDICAID ELIGIBILITY QUALITY CONTROL (MEQC) DISPOSITION LIST
0938-0170 Blood Bank Inspection Checklist and Report and Supporting Regulations in 42 CFR 493.1269-493-1285
0938-0169 QUESTIONNAIRE ON REGULATORY REFORM
0938-0167 TRIAGE--COORDINATED CARE OF THE ELDERLY (BILLING FORMS)
0938-0165 Prepaid Health Plan Cost Report
0938-0164 GPPP- SPECIAL ADMINISTRATIVE COST REPORT, QUARTERLY INVOICE & FINAL SPECIAL ADMINISTRATIVE COSTS
0938-0163 MEDICARE REIMBRUSEMENT SETTLEMENT DATA FOR HOME HEALTH AGENCIES
0938-0162 EVALUATION OF REIMBURSING FOR HOME DIALYSIS SERVICES
0938-0161 HEALTH PREPAYMENT DATA CARD CODING SHEET
0938-0160 LETTER TO COLLCT DATA ON STATE REGULATION OF MEDIGAP INSURANCE POLICIES
0938-0159 MEDICARE REIMBURSEMENT SETTLEMENT DATA FOR HOSPITALS AND SKILLED NURSING FACILITIES
0938-0157 NATIONAL ASSESSMENT OF MEDICARE DIAGNOSTIC AND SURGICAL DATA QUALITY
0938-0156 PILOT TEST OF REVISED MEDICAID AND INTEGRATED QUALITY CONTROL FORMS
0938-0155 Municipal Health Services Cost Report Form and Supporting Regulations 42 CFR 405.2470
0938-0153 PIP QUARTERLY REPORT FOR HOME HEALTH AGENCIES
0938-0152 NATIONAL SECOND SURGICAL OPINION PROGRAM - REACTION TO TELEVISION'S "20/20", UNNECESSARY SURGERY PROGRAM
0938-0151 Laboratory Personnel Report (CLIA) and Supporting Regulations (CMS-209)
0938-0150 BILLING FORMS FORM MEDICARE/MEDICAID HOSPICE DEMONSTRATION
0938-0149 EVALUATION OF THE SSOP MEDICARE DEMONSTRATIONS IN DETROIT AND NEW YORK AND THE MEDICAID PROGRAM IN MASSACHUSETTS
0938-0147 State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations
0938-0146 State Medicaid Eligibility Quality Control Sampling Plan (CMS-317)
0938-0145 REQUEST FOR MEDICARE PAYMENT BY MMHD FACILITY
0938-0144 Corrective Action Plan, Medicaid Eligibility Quality Control -- 42 CFR 431.800-820
0938-0143 FORM HCFA-231, "COMPENSATION SURVEY OF KEY ADMINISTRATIVE EMPLOYEES"
0938-0142 MEDICARE REIMBURSEMENT SETTLEMENT DATA FOR OUTPATIENT PHYSICAL THERAPY PROVIDERS
0938-0140 UNIFORM BILLING FORM
0938-0139 APPLICATION FOR FEDERAL ASSISTANCE FOR ESRD NETWORK COORDINATING COUNCIL
0938-0136 EVALUATION OF THE OKLAHOMA UTILIZATION REVIEW SYSTEM
0938-0134 SURVEY OF MEDICAID REIMBURSEMENT POLICIES
0938-0131 EVALUATION OF SECOND SURGICAL OPINION PROGRAMS FOR ELECTIVE SURGERY
0938-0119 PRESURGICAL SCREENING PROGRAM COST BENEFIT ANALYSIS QUESTIONNAIRE
0938-0117 UNIFORM BILL QUESTIONNAIRE
0938-0114 ESRDD DEMONSTRATION PROJECT COST REPORT
0938-0111 AMBULATORY HEALTH CARE CENTER STANDARDS FOR BUREAU OF COMMUNITY HEALTH SERVICES CENTERS
0938-0108 MEDICAID QUALITY CONTROL THIRD PARTY RESOURCE WORKSHEET (HCFA 301C) - (ADDENDUM) THIRD PARTY LIABILITY REVIEW WORKSHEET (HCFA-301D)
0938-0107 Rural Health Clinic Cost Report
0938-0106 HOME DIALYSIS TARGET RATE REIMBURSEMENT AGREEMENT AND INSTRUCTIONS
0938-0105 TUBERCULOSIS HOSPITAL REPORT FORM
0938-0104 PSYCHIATRIC HOSPITAL SURVEY REPORT FORM
0938-0103 PAPERWORK BURDEN ASSOCIATED WITH THE HOSPITAL SURVEY AND REQUEST TO ESTABLISH ELIGIBILITY
0938-0102 Organ Procurement Organization/Histocompatibility Laboratory Cost Report (CMS-216-94)
0938-0101 Medicaid Program Budget Report and Supporting Regs. (CMS-37)
0938-0100 MEDICARE/MEDICAID SKILLED NURSING FACILITY SURVEY REPORT
0938-0099 PENALTY REQUIREMENTS APPLICABLE TO THE EPSDT PROGRAM
0938-0097 CHILD HEALTH STATUS REPORT
0938-0094 Medicaid-Integrated Quality Control Review Manual Instructions and Supporting Regulations -- 42 CFR 431.800, .865
0938-0092 DEMONSTRATION PROJECT FOR CALCULATING ADJUSTED AVERAGE PER CAPITA COSTS
0938-0091 Requests for Medicare Payment by Municipal Health Services Program (MHSP) Clinics
0938-0089 'MEDICARE' REQUEST FOR CLAIM NUMBER VERIFICATION
0938-0088 HOSPITAL INTERIM RATE CHANGE REPORT (PIP QUARTERLY REPORT)
0938-0087 PSRO GRANT APPLICATION AND INSTRUCTIONS
0938-0086 Disclosure of Ownership and Financial Control Interest Statement and Supporting Regulations Contained in 42 CFR 420.200-.206 and 455.100-.106
0938-0085 PAPERWORK BURDEN ASSOCIATED WITH THE END-STAGE RENAL DISEASE FACILITY SURVEY
0938-0084 STERILIZATIONS AND HYSTERECTOMIES
0938-0083 REQUEST FOR ADDITIONAL MEDICAL INFORMATION
0938-0082 MEDICAID QUALITY CONTROL STATISTICAL REPORTS
0938-0081 INSTRUCTIONS FOR COMPLETION OF FEDERAL ASSISTANCE REPORTS--MEDICAID FRAUD
0938-0080 Application for Hospital Insurance Benefits Medicare for Individuals with End Stage Renal Disease and Supporting Regulations in 42 CFR 406.7 and 406.13 (CMS-43)
0938-0078 REQUEST FOR FEDERAL ASSISTANCE
0938-0077 PROGRAM INTEGRITY ACTIVITY REPORT (REVISION OF HCFA-52 FORMERLY CALLED OPI POSTPAYMENT REVIEW SUMMARY-MEDICAID)
0938-0076 MEDICAID/MEDICARE ABUSE REPORT
0938-0075 RURAL HEALTH CLINIC BILLING
0938-0074 (CMS-29) Request for Certification as Rural Health Clinic Form and Supporting Regulations
0938-0073 RURAL HEALTH CLINIC SURVEY REPORT
0938-0072 MEDICARE SECOND SURGICAL OPINION DEMONSTRATION PROJECTS
0938-0071 Physical Therapist in Independent Practice Survey Report
0938-0070 DELEGATED PROVIDER ADMISSIONS SUMMARY
0938-0069 MEDICAID QUALITY CONTROL REVIEW SCHEDULE AND WORKSHEET
0938-0067 Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program (CMS-64)
0938-0066 PHYSICIAN EXTENDERS REIMBURSEMENT STUDY
0938-0065 (CMS-1856) Outpatient Physical Therapy Speech Pathology Survey Report and Supporting Regulations
0938-0064 ESRD TRANSPLANT INFORMATION
0938-0063 PROFESSIONAL STANDARDS REVIEW ORGANIZATION ROUTINE FEDERAL REPORTING REQUIREMENTS
0938-0062 ICF/IID Survey Report Form (CMS-3070G-I) and Supporting Regulations
0938-0061 Quarterly Showing
0938-0060 MONTHLY STATISTICAL REPORT ON MEDICAL CARE
0938-0059 STATISTICAL REPORT ON MEDICAL CARE: RECIPIENTS, PAYMENTS, SERVICES
0938-0057 INDIVIDUALIZED SERVICE PLAN (SHORT FORM, EXTENDED FORM 1 AND 2)
0938-0056 HOSPITAL, HOSPITAL-SKILLED NURSING FACILITY COMPLEX, COST REPORT
0938-0055 MEDICARE REQUEST FOR APPROVAL AS A SUPPLIER OF ESRD SERVICES IN THE MEDICARE PROGRAM
0938-0054 HOSPITAL INSTITUTIONAL PLANNING QUESTIONNAIRE
0938-0053 SUMMARY OF DEFICIENCIES NOT CORRECTED
0938-0050 Hospitals and Health Care Complex Cost Report
0938-0049 LABORATORY PERSONNEL QUALIFICATION APPRAISAL
0938-0048 End Stage Renal Disease Death Notification
0938-0046 End Stage Renal Disease Medical Evidence Report Medicare Entitlement and/or Patient Registration (CMS-2728)
0938-0045 Request for Reconsideration of Part A Medicare Claim and Supporting Regulations in 42 CFR, 405.711
0938-0044 CONTRACTORS INFORMATION COLLECTIONS - STATE SURVEY AGENCY CORRECTION OF DEFICIENCY FORMS
0938-0043 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION AND CONTINUATION SHEET
0938-0042 Request for Medicare Payment -- Ambulance and Supporting Regulations in 42 CFR Sections 410.1, 410.40, 424.124, 424.601, 414.605, 414.610, 414.615, 414.620, 414.625, and 424.32
0938-0041 Third Party Premium Billing Request and Supporting Regulations in 42 CFR 408.6 and 408.202
0938-0039 PROVIDER CHAIN OPERATOR DATA
0938-0038 COST REPORT FORMS FOR GROUP PRACTICE PREPAYMENT PLANS WHICH DEAL DIRECTLY WITH HCFA
0938-0037 Community Mental Health Center (CMHC) Cost Report (CMS-2088-17)
0938-0036 REFERRAL AND TREATMENT PLAN
0938-0035 Social Security Office (SSO) Report of State Buy-in Problems (CMS-1957)
0938-0034 Request for Hearing for Part B Medicare Claim and Supporting Regulations in 42 CFR, 405.821
0938-0033 Request for Review of Part B Medicare Claim and Supporting Regulations in 42 CFR Sec. 405.807
0938-0032 MEDICARE/CLIA - DEPARTMENTAL CLINICAL LAB SURVEY REPORT FORM
0938-0031 DETERMINING LEVEL OF CARE REQUIRED BY PATIENT IN SKILLED NURSING FACILITY
0938-0027 (CMS-1880) Request for Certification as Supplier of Portable X-Ray and Portable X-Ray Survey Report Form
0938-0025 Request for Termination of Premium-Hospital and or Supplementary Medical Insurance and Supporting Regulations in 42 CFR 406.13 and 407.27 (CMS-1763)
0938-0023 Attending Physicians Statement and Documentation of Medicare Emergency and Supporting Regulations in 42 CFR Section 424.103 (CMS-1771)
0938-0022 Home Health Agency Cost Report and Supporting Regulations (CMS-1728-20)
0938-0021 PREPAYMENT PLAN FOR GROUP MEDICAL PRACTICES DEALING THROUGH A CARRIER
0938-0020 REQUEST FOR INFORMATION - MEDICARE PAYMENTS FOR SERVICES TO A PATIENT NOW DECEASED
0938-0016 PROVIDER BILLING FOR PATIENT SERVICES BY PHYSICIANS
0938-0015 INPATIENT ADMISSION AND BILLING-CHRISTIAN SCIENCE SANATORIUM
0938-0013 PROVIDER BILLING FOR MEDICAL AND OTHER HEALTH SERVICES
0938-0012 HOME HEALTH AGENCY, AND COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY, BILLING
0938-0011 HOME HEALTH AGENCY REQUEST FOR CERTIFICATION PAPERWORK BURDEN ASSOCIATED WITH HOME HEALTH
0938-0010 INPATIENT HOSPITAL AND SKILLED NURSING FACILITY ADMISSION AND BILLING
0938-0008 Health Insurance Common Claims Form and Supporting Regulations at 42 CFR Part 424, Subpart C
0938-0001 NATIONWIDE SURVEY OF INDEPENDENT PREPAID AND SELF-INSURED HEALTH PLANS

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