42 CFR 495.210(b) (2012) EPs-attestation

Medicare and Medicaid Programs; Electronic Health Record Incentive Program

OMB: 0938-1158

IC ID: 195504

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42 CFR 495.210(b) (2012) EPs-attestation
 
No New
 
Required to Obtain or Retain Benefits
 
42 CFR 495.210(b)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

12 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested 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 12 12 0 0 0 0
Annual IC Time Burden (Hours) 480 480 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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