Information Collection Request
Evaluation of the CMS Network of Quality Improvement and Innovation Contractors Program (NQIIC) (CMS-10769)
ICR 202401-0938-008 · OMB 0938-1424 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10769 Outpatient Clinician Survey |
Form and Instruction | New | Missing upstream |
| Form CMS-10769 HQIC Hospital Survey |
Form and Instruction | Modified | Repair queued |
| Form CMS-10769 NQIIC Nursing Home Survey |
Form and Instruction | Modified | Repair queued |
 CMS-10769 response to comments 1-11-24.docx |
Supplementary Document | Uploaded 2024-01-25 | Repair queued |
| CMS-10769_Supporting_Statement_B_3-2-2023.docx |
Supporting Statement B | Uploaded 2024-01-25 | Repair queued |
| CMS-10769_Supporting_Statement_A__1-10-24.docx |
Supporting Statement A | Uploaded 2024-01-26 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 264722 |  Outpatient Clinician Survey |
Form and Instruction | New | |
| 248181 | HQIC Hospital Survey |
Form and Instruction | Modified | |
| 248179 | NQIIC Nursing Home Survey |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1424 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202107-0938-001 |
| Agency Tracking No | CCSQ |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |