Business Proposal Forms For Quality Improvement Organizations (QIOs)

Business Proposal Forms For Quality Improvement Organizations (QIOs) (CMS-718-721)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0579 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-718-721 Business Proposal Forms For Quality Improvement Organizations (QIOs) Form
BP Instructions 508.pdf Instruction
CMS-718-721 Business Proposal Forms BP Forms.XLSX Form

Information Collection (IC) Details

IC Title:	Business Proposal Forms For Quality Improvement Organizations (QIOs)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			BP Instructions 508.pdf		Yes	Yes	Fillable Fileable
Form	CMS-718-721	Business Proposal Forms	BP Forms.XLSX		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	20	-1	21
Annual IC Time Burden (Hours)	1,000	-785	1,785
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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