OMB
.report
Search
Medicare Gainsharing Demonstration Evaluation: Physician Focus Groups (CMS-10303)
Medicare Gainsharing Demonstration Evaluation: Physician Focus Groups
OMB: 0938-1103
IC ID: 192883
OMB.report
HHS/CMS
OMB 0938-1103
ICR 201005-0938-004
IC 192883
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1103 can be found here:
2011-07-06 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
ATTACHMENT C and D.docx
Other-Advance Letters and Focus Grou
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Medicare Gainsharing Demonstration Evaluation: Physician Focus Groups (CMS-10303)
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-Advance Letters and Focus Group Discussion Protocol
ATTACHMENT C and D.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
77
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
77
0
77
0
0
0
Annual IC Time Burden (Hours)
77
0
77
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.