Information Collection Request

Marketplace Quality Standards (CMS-10520)

ICR 201603-0938-008 · OMB 0938-1249 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10520 Vendor Appeal Form Form and Instruction Unchanged Available
CMS-10520 - Quality Standards Supporting Statement 2016.pdf Supporting Statement A Uploaded 2016-06-16 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
212995 Patient safety reporting standards for QHP issuers Modified
212994 Reporting for the Enrollee Satisfaction Survey (ESS) Unchanged
212992 Implementation and reporting for the Quality Rating System (QRS) Unchanged
212011 Monitoring and appeals process for survey vendors Form and Instruction UnchangedVendor Appeal Form

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2019 36 Months From Approved 09/30/2017
1,770 0 1,770
1,085,095 0 1,084,495
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Implementation and reporting for the Quality Rating System (QRS)
Monitoring and appeals process for survey vendors CMS-10520
Patient safety reporting standards for QHP issuers
Reporting for the Enrollee Satisfaction Survey (ESS)

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,770 1,770 0 0 0 0
Annual Time Burden (Hours) 1,085,095 1,084,495 600 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No