Important Message From Medicare

Hospital Notices: IM / DND (CMS-10065/10066)

OMB: 0938-1019

IC ID: 237581

Information Collection (IC) Details

View Information Collection (IC)

Important Message From Medicare CM-CPC
 
No Modified
 
Mandatory
 
42 CFR 405.1205     42 CFR 422.620 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction CMS_10065_IMinstructions_2022_OSORA.pdf No   Paper Only
Form and Instruction CMS-100065/10066 Important Message from Medicare CMS-10655_IM_2022_v508_OSORA.pdf No   Paper Only
Form and Instruction CMS-10065/10066 Important Message from Medicare CMS10065_IM_Spanish_2022.docx No   Paper Only

Health Health Care Services

 

4,312 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Requested 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 14,042,374 0 0 0 0 14,042,374
Annual IC Time Burden (Hours) 2,340,396 0 0 0 0 2,340,396
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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