The Fiscal Soundness Reporting Requirements (CMS-906)

Fiscal Soundness Reporting Requirements (FSRR) (CMS-906)

OMB: 0938-0469

IC ID: 8094

Documents and Forms
Document Name
Document Type
Form and Instruction
Instruction
Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

The Fiscal Soundness Reporting Requirements (CMS-906)
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 516(a)(5) 42 CFR 460.208 42 CFR 423.514  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-906 Health Plan Management System (HPMS) Collection Instrument and Instructions_11.19.2021.pdf Yes Yes Fillable Fileable Signable
Instruction FSMPlanUserGuide.pdf No   Printable Only

Health Health Care Services

 

936 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,958 0 0 369 0 1,589
Annual IC Time Burden (Hours) 653 0 0 123 0 530
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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