Information Collection

HEDIS Information Collection Request

IC 181326 under ICR 202402-0938-002 · OMB 0938-1028.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment HEDIS Measures and Descriptions HEDIS 2023.pdf	Other-HEDIS® 2023 Measures and Descr
Attachment HEDIS Measures and Descriptions HEDIS 2023.pdf	Other-HEDIS® 2023 Measures and Descr

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 422.152

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
Other-HEDISÂ® 2023 Measures and Descriptions for Medicare					Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Health Plan Management System (HPMS)

FR Citation: 83 FR 6591

Number of Respondents: 808

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	808	131	677
Annual IC Time Burden (Hours)	258,560	41,920	216,640
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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