Information Collection Request

(CMS-10336) Medicare and Medicaid Programs; Promoting Interoperability Program

ICR 201806-0938-007 · OMB 0938-1158 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10336.Supporting Statement Part A 6-21-18.docx Supporting Statement A Uploaded 2018-06-22 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
208653 495.342 - Frequency of Health Information Technology (HIT) Implementation Advanced Planning Document (IAPD) Updates Removed
208652 495.210 - Total cost of attestation for Stage 2 (MA-affiliated hospitals) Removed
208651 495.210 - Attesting on behalf of MA-affiliated hospitals Removed
208650 495.210 - Gather information for attestation (MA-affiliated hospitals) Removed
208649 495.210 - Total Cost of Attestation for Stage 2 (MA EPs) Removed
208648 495.210 - Attesting on behalf of MA EPs Removed
208647 495.210 - Gather information for attestation (MA EPs) Removed
208646 495.8 - CQMs for hospitals/CAHS Removed
208645 495.6 - Menu Set Objectives/Measures (Hospitals/CAHs) Removed
208644 495.6 - EHR Technology Used, Core Set Objectives/Measures (Hospitals/CAHS) Removed
208643 495.8 - CQMs for hospitals/CAHs Removed
208642 495.6 - Menu Set Objectives/Measures (EPs) average Removed
208641 495.6 EHR Technology Used, Core Set Objectives/Measures (EPs) Removed
195516 42 CFR 495.366 -- average Removed
195515 42 CFR 495.352 -- average Removed
195514 42 CFR 495.350--average Removed
195513 42 CFR 495.348(f) Removed
195512 42 CFR 495.348(e) Removed
195511 42 CFR 495.348(c) Removed
195510 42 CFR 495.330(a) - average Removed
195509 42 CFR 495.316 Removed
195508 42 CFR 495.306(a)(2) Removed
195507 42 CFR 495.306(a)(1)(ii)(B) Removed
195506 42 CFR 495.306(a)(1)(ii)(A) Removed
195505 42 CFR 495.22(c) Medicare eligible hospitals Modified
195504 42 CFR 495.210(b) (2012) EPs-attestation Removed
195503 42 CFR 495.204(b)(5) or (b)(6)(2012) EPs-salary Removed
195502 42 CFR 495.204(b)(4) (2012) EPs-method Removed
195501 42 CFR 495.2(e) Medicaid eligible hospitals Modified
195500 42 CFR 495.202(b)(2) (2012) MA-affiliated hospitals-final ID Removed
195499 42 CFR 495.202(b)(2) (2012) EPs-final ID Removed
195498 42 CFR 495.202(b)(2) (2012) MA-affiliated hospitals-preliminary ID Removed
195497 42 CFR 495.202(b)(2) (2012) EPs-preliminary ID Removed
195496 42 CFR 495.10(d) - (hospital) (2012) Removed
195495 42 CFR 495.342 Frequency of Health Information Technology (HIT) Implementation Advanced Planning Document (IAPD) Updates Modified
195494 42 CFR 495.10(e)(2) - (EPs) (2012) average Removed
195493 42 CFR 495.10(e)(1) - (EPs) (2011) average Removed
195492 42 CFR 495.10(d) - (EPs) (2012) average Removed
195491 42 CFR 495.10(a)-(c) -- (EPs) (2011) average Removed
195490 42 CFR 495.8 (b)(2)- Hospital Quality Measures (hospitals/CAHs) (2012) Removed
195489 42 CFR 495.8 (b)(2)- Menu Set Objectives/ Measures average (hospitals/CAHs) (2012) Removed
195488 42 CFR 495.8 (b)(2)-- EHR Technology Used & Core Set Objectives/Measures (hospitals/CAHs) (2012) Removed
195487 42 CFR 495.8(b)(1) - Menu Set Objectives/ Measures average (hospitals/CAHs) (2011) Removed
195486 42 CFR 495.8 (b)(1)-- EHR Technology Used, Core Set Objectives/Measures & Quality Measures (hospitals/CAHs) (2011) Removed
195485 42 CFR 495.8 (a)(2)- Ambulatory Quality Measures (EPs) (2012) Removed
195484 42 CFR 495.8 (a)(2)- Menu Set Objectives/ Measures average (EPs) (2012) Removed
195483 42 CFR 495.8(a)(2) - EHR Technology Used & Core Set Objectives/Measures (EPs) (2012) Removed
195482 42 CFR 495.8 (a)(1)- Menu Set Objectives/Measures average (EPs) (2011) Removed
195481 42 CFR 495.22 Medicaid EPs Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2021 36 Months From Approved 12/31/2018
83,489 0 4,495,264
575,427 0 4,792,112
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
42 CFR 495.330(a) - average
42 CFR 495.350--average
42 CFR 495.366 -- average
495.210 - Total Cost of Attestation for Stage 2 (MA EPs)
495.210 - Gather information for attestation (MA-affiliated hospitals)
495.8 - CQMs for hospitals/CAHS
495.210 - Gather information for attestation (MA EPs)
42 CFR 495.8 (b)(1)-- EHR Technology Used, Core Set Objectives/Measures & Quality Measures (hospitals/CAHs) (2011)
42 CFR 495.8 (a)(1)- Menu Set Objectives/Measures average (EPs) (2011)
42 CFR 495.8(a)(2) - EHR Technology Used & Core Set Objectives/Measures (EPs) (2012)
42 CFR 495.8(b)(1) - Menu Set Objectives/ Measures average (hospitals/CAHs) (2011)
42 CFR 495.22 Medicaid EPs
42 CFR 495.10(e)(1) - (EPs) (2011) average
42 CFR 495.10(d) - (hospital) (2012)
42 CFR 495.202(b)(2) (2012) MA-affiliated hospitals-preliminary ID
42 CFR 495.202(b)(2) (2012) MA-affiliated hospitals-final ID
42 CFR 495.306(a)(1)(ii)(A)
42 CFR 495.348(c)
42 CFR 495.348(f)
495.210 - Total cost of attestation for Stage 2 (MA-affiliated hospitals)
42 CFR 495.352 -- average
42 CFR 495.342 Frequency of Health Information Technology (HIT) Implementation Advanced Planning Document (IAPD) Updates
495.6 EHR Technology Used, Core Set Objectives/Measures (EPs)
495.8 - CQMs for hospitals/CAHs
42 CFR 495.2(e) Medicaid eligible hospitals
42 CFR 495.204(b)(4) (2012) EPs-method
42 CFR 495.204(b)(5) or (b)(6)(2012) EPs-salary
42 CFR 495.210(b) (2012) EPs-attestation
42 CFR 495.316
495.6 - Menu Set Objectives/Measures (Hospitals/CAHs)
495.210 - Attesting on behalf of MA EPs
495.210 - Attesting on behalf of MA-affiliated hospitals
42 CFR 495.202(b)(2) (2012) EPs-final ID
42 CFR 495.348(e)
495.6 - Menu Set Objectives/Measures (EPs) average
495.6 - EHR Technology Used, Core Set Objectives/Measures (Hospitals/CAHS)
42 CFR 495.22(c) Medicare eligible hospitals
42 CFR 495.306(a)(1)(ii)(B)
42 CFR 495.306(a)(2)
42 CFR 495.8 (a)(2)- Menu Set Objectives/ Measures average (EPs) (2012)
42 CFR 495.8 (a)(2)- Ambulatory Quality Measures (EPs) (2012)
495.342 - Frequency of Health Information Technology (HIT) Implementation Advanced Planning Document (IAPD) Updates
42 CFR 495.8 (b)(2)-- EHR Technology Used & Core Set Objectives/Measures (hospitals/CAHs) (2012)
42 CFR 495.8 (b)(2)- Menu Set Objectives/ Measures average (hospitals/CAHs) (2012)
42 CFR 495.8 (b)(2)- Hospital Quality Measures (hospitals/CAHs) (2012)
42 CFR 495.10(a)-(c) -- (EPs) (2011) average
42 CFR 495.10(d) - (EPs) (2012) average
42 CFR 495.10(e)(2) - (EPs) (2012) average
42 CFR 495.202(b)(2) (2012) EPs-preliminary ID

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 83,489 4,495,264 0 -3,158,886 -1,252,889 0
Annual Time Burden (Hours) 575,427 4,792,112 0 -2,821,539 -1,395,146 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No