Information Collection Request

Implementation of Medicare and Medicaid Programs; - Promoting Interoperability Programs Stage 3 (CMS-10552)

ICR 202007-0938-004 · OMB 0938-1278 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10552 Online Attestation Forms Form and Instruction Modified Available
CMS-10552_Supporting_Statement_Part_A_07-10-20.docx Supporting Statement A Uploaded 2020-07-15 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
231472 §495.24(d) Objectives/Measures Medicaid (eligible hospitals/CAHs) Unchanged
216085 §495.316 – Quarterly Reporting Unchanged
216082 §495.24(e) Objectives/Measures (hospitals/CAHs) Unchanged
216075 § 495.24(d)-Objectives/Measures (EPs) Form and Instruction ModifiedOnline Attestation Forms
216075 § 495.24(d)-Objectives/Measures (EPs) Instruction 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 12/31/2021
83,657 0 83,657
621,318 0 621,318
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
§ 495.24(d)-Objectives/Measures (EPs) CMS-10552
§495.24(d) Objectives/Measures Medicaid (eligible hospitals/CAHs)
§495.24(e) Objectives/Measures (hospitals/CAHs)
§495.316 – Quarterly Reporting



Reginfo record details
  No