Information Collection

Consumer Research on Public Reporting of Hospital Outpatient Measures (CMS-10360) - Hospital Professional Interviews Round 1

IC 196981 under ICR 201103-0938-005 · OMB 0938-1143.

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Information Collection (IC) Details

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IC Title:	Consumer Research on Public Reporting of Hospital Outpatient Measures (CMS-10360) - Hospital Professional Interviews Round 1	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 1395

Information Collection Instruments:

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

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 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	6	0	0	0	0	0
Annual IC Time Burden (Hours)	15	0	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.