Crosswalk

Change
Form 0235 DUA

Detailed Information
made updates to the language

Added State Agency Supplement

This form provides information on the research
study, the minimum data necessary to support
the research study, and how the research
results will be made publicly available.
The State Agency Supplement to the RIF
Application provides information on data reuse
and re-disclosure that is specific to State
Agencies conducting research.

Added Virtual Research Data Center
Supplement

This form collects information specific to
researchers that will be utilizing the Virtual
Research Data Center, secure CMS
environment that provides researchers with
direct access to approved privacy-protected
data files to conduct their research analyses.

Added RIF DUA Attachment A – RIF
Request Application

Reason for the change
the updated language clarifies the data
release policies

Impact on
Burden
none

Adding standard forms used in the research
request packet
add

Adding standard forms used in the research
request packet
add

Adding standard forms used in the research
request packet
add

Added Amendment Request form

This form collects information specific to
researchers that will be utilizing the Virtual
Research Data Center (VRDC) as part of the
Innovator Program. The VRDC is secure CMS
environment that provides researchers with
direct access to approved privacy-protected
data files to conduct their research analyses.
This form provides information on any
collaborating organizations that will be
assisting the research requester with the
research study.
This form provides information on the
individuals that play key roles in the research
study.
This form allows a requester to amend an
existing DUA, such as add new data

Added Certificate of Disposition

This form is in another PRA package and is used
to close a DUA and certify that data is
destroyed. The form was updated to request
information on different destruction
approaches and take into account the different
ways to access CMS data.
this reflects updated CMS policies

none

Added DMP SAQ Questionnaire with
updated language

The DMP SAQ will enable CMS to evaluate
researcher data systems to ensure that CMS
data are adequately secured and appropriately
protected, as per the Privacy Act and the HIPAA
Privacy Rule. The DMP SAQ Questionnaire was
updated to add secondary contact information. combining PRA packages

add

Renamed Virtual Research Data Center
Supplement to Innovator Supplement

Added Collaborator Supplement

Added Key Personnel Supplement

The form was renamed to specify that it is
only for researchers accessing the data
through the innvoator program and is not
applicable to all researchers accessing data
in the VRDC.

none

including forms in the RIF request packet

add

Adding standard forms used in the research
request packet
add
Adding standard forms used in the research
request packet
add