Information Collection

The Medicare Acute Care Episode Demonstration (CMS-10317)

IC 194759 under ICR 201009-0938-019 · OMB 0938-1117.

Documents and Forms

Document Name Document Type
ACE OMB FocusGroup-and-Interview Protocols.pdf Other-Focus Group and Interview Prot
ACE OMB SiteVisitCorrespondence.pdf ACE OMB SiteVisitCorrespondence IC Document
ACE OMB SiteVisit_2_Correspondence.pdf ACE OMB SiteVisit_2_Correspondence IC Document
ACE OMB MMA.pdf ACE OMB MMA IC Document
ACE OMB Social Security Act.pdf ACE OMB Social Security Act IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	The Medicare Acute Care Episode Demonstration (CMS-10317)	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-Focus Group and Interview Protocols			ACE OMB FocusGroup-and-Interview Protocols.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 509	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	509	509
Annual IC Time Burden (Hours)	764	764
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
ACE OMB SiteVisitCorrespondence	ACE OMB SiteVisitCorrespondence.pdf	09/09/2010
ACE OMB SiteVisit_2_Correspondence	ACE OMB SiteVisit_2_Correspondence.pdf	09/09/2010
ACE OMB MMA	ACE OMB MMA.pdf	09/09/2010
ACE OMB Social Security Act	ACE OMB Social Security Act.pdf	09/09/2010

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