OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Medicare and Medicare Advantage Programs; Notification Procedures for Hospital Discharges Detailed Notice of Discharge (CMS-10066)

IC 179807 under ICR 200704-0938-010 · OMB 0938-1019.

Documents and Forms
Document Name
Document Type
Form
Instruction
Other-Revised Detail
Other-Revised Notice Instructions
Other-Summary of Changes
Form
Information Collection (IC) Details

View Information Collection (IC)

Medicare and Medicare Advantage Programs; Notification Procedures for Hospital Discharges Detailed Notice of Discharge (CMS-10066)
 
No New
 
Mandatory
 
42 CFR 405.1206 42 CFR 422.622

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10066 DETAILED NOTICE OF DISCHARGE CMS-10066 Revised DRAFT Detailed Notice of Discharge March 2007.doc Yes Yes Paper Only
Instruction CMS 10066 Notice Instructions Detailed Notice of Discharge March 2007.doc Yes Yes Paper Only
Other-Revised Notice Instructions Revised Detailed Notice Instructions for OMB 05 16 07.doc Yes Yes Paper Only
Other-Summary of Changes Summary of changes made to Detailed Notice 05 16 07.doc Yes Yes Paper Only
Other-Revised Detail Revised Detailed for OMB 05 16 07.doc Yes Yes Paper Only

Health Health Care Services

 

6,000 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 130,000 0 130,000 0 0 0
Annual IC Time Burden (Hours) 130,000 0 130,000 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.