Information Collection Request
Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network (CROWNWeb) (CMS-10569)
ICR 202211-0938-004 · OMB 0938-1289 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1289 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 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 | Modified | Available |
| 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 | Modified | Missing upstream |
 CMS-10569 Supporting Statement A EQRS CY 2023 (10-20-2022) (3).docx |
Supporting Statement A | Uploaded 2022-11-09 | Available |
| CMS-10569 Supporting Statement A EQRS CY 2023 (10-20-2022) (3).docx |
Supporting Statement A | Uploaded 2022-11-09 | Repair queued |
| CMS-10569 Supporting Statement B EQRS CY 2023 (10-20-2022) (1).docx |
Supporting Statement B | Uploaded 2022-11-09 | Available |
| CMS-10569 Supporting Statement B EQRS CY 2023 (10-20-2022) (1).docx |
Supporting Statement B | Uploaded 2022-11-09 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 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 | Modified | |
| 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 | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1289 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202207-0938-011 |
| Agency Tracking No | CCSQ |
| Date Submitted to OIRA | 2022-11-10 |
| Requested Expiration Date | 1969-12-31 |