Evaluation of the Medicare National Competitive Bidding Program for DME

Evaluation of Medicare National Competitive Bidding Program for DME

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1015 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10197 Evaluation of the Medicare National Competitive Bidding Program for DME Form and Instruction
CMS-10197 Surveys and Evaluation Program Handbook CMS-10197 OMB_DMEBID_Statement and Appendices 11-20-06.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Evaluation of the Medicare National Competitive Bidding Program for DME	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10197	Surveys and Evaluation Program Handbook	CMS-10197 OMB_DMEBID_Statement and Appendices 11-20-06.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 665	Number of Respondents for Small Entity: 665

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 86 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	665	665
Annual IC Time Burden (Hours)	551	551
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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