Evaluation of the Medicare Care Management Performance Demonstration (CMS-10256): Benefifiary Survey

Evaluation of the Medicare Care Management Performance Demonstration

Documents and Forms

Document Name Document Type
MCMP-OMB-Combined Final (5-29-08).pdf Other-Surveys

Information Collection (IC) Details

IC Title:	Evaluation of the Medicare Care Management Performance Demonstration (CMS-10256): Benefifiary Survey	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
Other-Surveys			MCMP-OMB-Combined Final (5-29-08).pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,800	4,800
Annual IC Time Burden (Hours)	1,200	1,200
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.