42 CFR 489.20(u)(1) - Attestation of non-Referring Status (Attorney)

Disclosures Required Regarding Physician Ownership and On-site Availability of an MD/DO (CMS-10225)

OMB: 0938-1034

IC ID: 186811

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42 CFR 489.20(u)(1) - Attestation of non-Referring Status (Attorney)
 
No Modified
 
Mandatory
 
42 CFR 489.20(u)(2)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

81 0
   
Private Sector Businesses or other for-profits
 
   0 %

  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 81 0 0 54 0 27
Annual IC Time Burden (Hours) 81 0 0 54 0 27
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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