Crosswalk

Change crosswalk 6-16.pdf

Data Request and Attestation for PDP Sponsors (CMS-10691)

Crosswalk

OMB: 0938-1371

Document [pdf]
Download: pdf | pdf
Change

Change in data requester
Provided for updates to data request
and attestations

Added a AB2D Data Operations
Specialist (ADOS) Form
Added an Onboarding Pre-requesite
Form

Detailed Information

Reason for the change

The indiviudal that submits the data request
and attestation is a Chief Executive, not a
business operations specialist. Chief Executive
15 minutes at $74.00204.82/hr to complete the
request for data and the attestation.

This is who provides the information in
HPMS.

Accounted for updates to the data request and
attestation if the original attestor is replaced.
This form is filled out by the Chief Executive
and provides contact information for an AB2D
Data Operations Specialist (ADOS) who will be
their organizations primary technical point of
contact for the AB2D API.
This form collects information for on-boarding
pre-requisites from the ADOS.

Need to account for updates to the data
request and attestations.

Impact
on
Burden
Add, the
hourly
wage
increased
from $74
to
$204.82.

add

This information is needed to access claims
data.
add
This information is needed to connect to the
API to access claims data.
add


File Typeapplication/pdf
File TitleChange Crosswalk
AuthorKari Gaare
File Modified2022-06-23
File Created2022-06-23

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