The Medicare Acute Care Episode Demonstration (CMS-10317)

The Medicare Acute Care Episode Demonstration

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

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.