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Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments Supporting Reg 42 CFR Part 422 & 423 Subparts F and G
Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments (CMS-10062)
OMB: 0938-0878
IC ID: 8704
OMB.report
HHS/CMS
OMB 0938-0878
ICR 201609-0938-021
IC 8704
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0878 can be found here:
2023-03-30 - Revision of a currently approved collection
2020-03-12 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments Supporting Reg 42 CFR Part 422 & 423 Subparts F and G
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
42 CFR 422.250-422.324
42 CFR 423.251-423.350
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
CMS Risk Adjustment Suite of Systems (RASS), HHS/CMS/CM
FR Citation:
80 FR 49237
Number of Respondents:
691
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 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
82,830,000
0
0
0
0
82,830,000
Annual IC Time Burden (Hours)
40,650
0
0
0
0
40,650
Annual IC Cost Burden (Dollars)
0
0
0
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.