Appeals of Quality Bonus Payment Determinations (CMS-10346)

Appeals of Quality Bonus Payment Determinations

OMB: 0938-1129

IC ID: 195883

Information Collection (IC) Details

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Appeals of Quality Bonus Payment Determinations (CMS-10346)
 
No Modified
 
Voluntary
 
42 CFR 422.260

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10346 Request for Reconsideration Request_For_Reconsideration_Form_2015.pdf Yes Yes Fillable Printable

Health Health Care Services

 

25 0
   
Private Sector Businesses or other for-profits
 
   100 %

  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 25 0 0 0 0 25
Annual IC Time Burden (Hours) 200 0 0 0 0 200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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