Tracking the adoption of alternative payment models (CMS-10620)

Generic Clearance for the Heath Care Payment Learning and Action Network (CMS-10575)

Documents and Forms

Document Name Document Type
Form CMS-10620 Tracking the adoption of alternative payment models (CMS-10620) Form and Instruction
CMS-10620 Informational Questions 5. 2022 LAN Informational Questions.docx Form and Instruction
CMS-10620 National Data Collection Metrics 6. 2022 APM National Data Collection Metrics_04192022.xlsx Form and Instruction
CMS-10620 LAN Informational Questions 5. 2022 LAN Informational Questions.docx Form and Instruction
2. CMS-10620 GenIC - Supporting Statement - 4.1.2022.docx Supporting Statement IC Document
1. 2022 National APM Metric Overview_4.1.2022.docx National APM Metric Overview IC Document
3. 2022 -APM-Measurement-FAQ_05.09.2022.docx APM-Measurement-FAQ IC Document

Information Collection (IC) Details

IC Title:	Tracking the adoption of alternative payment models (CMS-10620)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10620	Informational Questions	5. 2022 LAN Informational Questions.docx	Yes	Yes	Fillable Printable
Form and Instruction	CMS-10620	National Data Collection Metrics	6. 2022 APM National Data Collection Metrics_04192022.xlsx	Yes	Yes	Fillable Printable
Form and Instruction	CMS-10620	LAN Informational Questions	5. 2022 LAN Informational Questions.docx	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	1,350	1,350
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	2. CMS-10620 GenIC - Supporting Statement - 4.1.2022.docx	08/22/2022
National APM Metric Overview	1. 2022 National APM Metric Overview_4.1.2022.docx	08/22/2022
APM-Measurement-FAQ	3. 2022 -APM-Measurement-FAQ_05.09.2022.docx	08/22/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.