HEDIS Information Collection Request

HEDIS Data Collection for Medicare Advantage (CMS-10219)

Documents and Forms

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

Information Collection (IC) Details

IC Title:	HEDIS Information Collection Request	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-HEDIS® 2023 Measures and Descriptions for Medicare			Attachment HEDIS Measures and Descriptions HEDIS 2023.pdf		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: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	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

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.