Information Collection

(Quality Performance Category) Group Registration for CMS Web Interface (see SS-A Table 14)

IC 227505 under ICR 201812-0938-013 · OMB 0938-1314.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1314 can be found here:

Documents and Forms

Document Name Document Type
Appendix C 2018 CAHPS for MIPS and Web Interface Registration Guide (version 2).docx Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	(Quality Performance Category) Group Registration for CMS Web Interface (see SS-A Table 14)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 414.1330 and 414.1335

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Appendix C 2018 CAHPS for MIPS and Web Interface Registration Guide (version 2).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 67	Number of Respondents for Small Entity: 67

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	67	57	10
Annual IC Time Burden (Hours)	17	7	10
Annual IC Cost Burden (Dollars)	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.