Information Collection Request

Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network (CROWNWeb) (CMS-10569)

ICR 202106-0938-014 · OMB 0938-1289 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10569 : End-Stage Renal Disease Quality Incentive Program: Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network Form and Instruction Unchanged Repair queued
CMS-10569 Supporting Statement B EQRS CY 2022 (6-23-2021).docx Supporting Statement B Uploaded 2021-06-28 Missing upstream
CMS-10569 Supporting Statement A EQRS CY 2022 (6-23-2021).docx Supporting Statement A Uploaded 2021-06-28 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
217583 : End-Stage Renal Disease Quality Incentive Program: Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 04/30/2024
532,931 532,931
3,390,283 3,390,283
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
: End-Stage Renal Disease Quality Incentive Program: Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network CMS-10569, CMS-10569 Letter to Facilities - data collection ,   EQRS Global App

table that charts list of burden
  Total Request 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 532,931 532,931 0 0 0 0
Annual Time Burden (Hours) 3,390,283 3,390,283 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No