Information Collection Request

Programs of All-Inclusive Care for the Elderly (PACE) PACE Quality Data Monitoring and Reporting (10525)

ICR 202312-0938-001 · OMB 0938-1264 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10525 - Supporting Statement A v2.docx Supporting Statement A Uploaded 2023-12-08 Repair queued
Appendix A-CMS 10525 Response to Public Comments 60 day 11.2023.docx Supplementary Document Uploaded 2023-12-01 Repair queued
CMS 10525 PRA Crosswalk 2023.pdf Supplementary Document Uploaded 2023-12-01 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
214270 PACE Quality Data With RCA Instruction Modified
213217 PACE Quality Data Without RCA Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 12/31/2023
1,279 1,143
223,592 173,664
0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
PACE Quality Data With RCA
PACE Quality Data Without RCA

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,279 1,143 0 0 136 0
Annual Time Burden (Hours) 223,592 173,664 0 0 49,928 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No