Information Collection

Quality Improvement of IPPTA Processes and Procedures

IC 279592 under ICR 202211-0938-011 · OMB 0938-1185.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form CMS-10894
Preparation: SMEs for IPPTA Quality Improvement of IPPTA Processes and Procedures
Form and Instruction
Form CMS-10894
Data documentation Submission and Sampling Quality Improvement of IPPTA Processes and Procedures
Form and Instruction
Form CMS-10894
Conduct Reviews Quality Improvement of IPPTA Processes and Procedures
Form and Instruction
Form CMS-10894
Observation and Collaboration Quality Improvement of IPPTA Processes and Procedures
Form and Instruction
Form CMS-10894
SBE Closeout Quality Improvement of IPPTA Processes and Procedures
Form and Instruction
CMS-10894 Preparation: SMEs for IPPTA
Workstream 1_ Prepare SBEs for IPPTA.html

forms.office.com/Pages/ResponsePage.aspx?id=we3c-6lwS0G_pcMGP8M5XsTeH2nprjVNtlV_jBxTcVtUREFXV0lQWUhOM0YxOUpIOVhBU1c5MlJQ
Form and Instruction
CMS-10894 Data documentation Submission and Sampling
Workstream 2_ Data Documentation Submission and Sampling.html

forms.office.com/Pages/ResponsePage.aspx?id=we3c-6lwS0G_pcMGP8M5XsTeH2nprjVNtlV_jBxTcVtUNjVZU1BNT0tTTDJQT0lTS0Y1QlkwNTUw
Form and Instruction
CMS-10894 Conduct Reviews
Workstream 3_ Conduct Reviews.html

forms.office.com/Pages/ResponsePage.aspx?id=we3c-6lwS0G_pcMGP8M5XsTeH2nprjVNtlV_jBxTcVtURTlTTFBCSUlONVRYNkc2SEVPWVJBNTU4
Form and Instruction
CMS-10894 Observation and Collaboration
Workstream 4_ Observation and Collaboration.html

forms.office.com/Pages/ResponsePage.aspx?id=we3c-6lwS0G_pcMGP8M5XsTeH2nprjVNtlV_jBxTcVtURDBVUEhRT0VLQzZXRVNFT1FNMTkwVU5V
Form and Instruction
CMS-10894 SBE Closeout
Workstream 5_ SBE Closeout.html

forms.office.com/Pages/ResponsePage.aspx?id=we3c-6lwS0G_pcMGP8M5XsTeH2nprjVNtlV_jBxTcVtURElIMDEwSVhaVFhIV0o5TjdVV1lNVTc1
Form and Instruction
CMS-10894 - IPPTA Fast-Track Form.docx
IPPTA Fast-Track Form
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10894 https://forms.office.com/Pages/ResponsePage.aspx?id=we3c-6lwS0G_pcMGP8M5XsTeH2nprjVNtlV_jBxTcVtUREFXV0lQWUhOM0YxOUpIOVhBU1c5MlJQTy4u Yes Yes Fillable Fileable
Form and Instruction CMS-10894 https://forms.office.com/Pages/ResponsePage.aspx?id=we3c-6lwS0G_pcMGP8M5XsTeH2nprjVNtlV_jBxTcVtUNjVZU1BNT0tTTDJQT0lTS0Y1QlkwNTUwQi4u Yes Yes Fillable Fileable
Form and Instruction CMS-10894 https://forms.office.com/Pages/ResponsePage.aspx?id=we3c-6lwS0G_pcMGP8M5XsTeH2nprjVNtlV_jBxTcVtURTlTTFBCSUlONVRYNkc2SEVPWVJBNTU4Ny4u Yes Yes Fillable Fileable
Form and Instruction CMS-10894 https://forms.office.com/Pages/ResponsePage.aspx?id=we3c-6lwS0G_pcMGP8M5XsTeH2nprjVNtlV_jBxTcVtURDBVUEhRT0VLQzZXRVNFT1FNMTkwVU5VNS4u Yes Yes Fillable Fileable
Form and Instruction CMS-10894 https://forms.office.com/Pages/ResponsePage.aspx?id=we3c-6lwS0G_pcMGP8M5XsTeH2nprjVNtlV_jBxTcVtURElIMDEwSVhaVFhIV0o5TjdVV1lNVTc1OS4u Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 19 0 19 0 0 0
Annual IC Time Burden (Hours) 228 0 228 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
IPPTA Fast-Track Form 03/23/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].