LAN Documents (CMS-10606, CMS-10607 and CMS-10608)

Generic Clearance for the Heath Care Payment Learning and Action Network (CMS-10575)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1297 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10606 LAN Documents (CMS-10606, CMS-10607 and CMS-10608) Form and Instruction
CMS-10606 Speaker Request Form CMS- 10606 GenIC4 Instrument - Speaker Request Form.pdf Form and Instruction
CMS-10608 Webinar Registration - LAN update CMS-10608 GenIC6 Instrument - Webinar Registration Form.pptx Form and Instruction
CMS-10607 Webinar Registration - LAN Learning CMS- 10607 GenIC5 Instrument - Webinar Registration Form.pptx Form and Instruction
0938-1297 Burden Table for GenICs 4 5 and 6.docx 0938-1297 Burden Table for GenICs 4 5 and 6 IC Document
CMS-10606 GenIC4 Speaker Request Form v2.docx CMS-10606 Supporting Statement IC Document
CMS-10607 GenIC5 Webinar Registration - LAN Learnings v2.docx CMS-10607 Supporting Statement IC Document
CMS-10608 GenIC6 Webinar Registration - LAN Updates v2.docx CMS-10608 Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	LAN Documents (CMS-10606, CMS-10607 and CMS-10608)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10606	Speaker Request Form	CMS- 10606 GenIC4 Instrument - Speaker Request Form.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	CMS-10608	Webinar Registration - LAN update	CMS-10608 GenIC6 Instrument - Webinar Registration Form.pptx	Yes	Yes	Fillable Fileable
Form and Instruction	CMS-10607	Webinar Registration - LAN Learning	CMS- 10607 GenIC5 Instrument - Webinar Registration Form.pptx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13,224	Number of Respondents for Small Entity: 2,645

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
Annual Number of Responses for this IC	13,224	13,224
Annual IC Time Burden (Hours)	666	666
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0938-1297 Burden Table for GenICs 4 5 and 6	0938-1297 Burden Table for GenICs 4 5 and 6.docx	03/07/2016
CMS-10606 Supporting Statement	CMS-10606 GenIC4 Speaker Request Form v2.docx	03/14/2016
CMS-10607 Supporting Statement	CMS-10607 GenIC5 Webinar Registration - LAN Learnings v2.docx	03/14/2016
CMS-10608 Supporting Statement	CMS-10608 GenIC6 Webinar Registration - LAN Updates v2.docx	03/14/2016

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