Information Collection Request
National Implementation of the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey (CMS-10500)
ICR 202402-0938-009 · OMB 0938-1240 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1240 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10500 HOPDs/ASCs Patient Records |
Form and Instruction | Modified | Repair queued |
| Form CMS-10500 National Implementation |
Form | Modified | Missing upstream |
 CMS-10500-SupportingStatement-A.docx |
Supporting Statement A | Uploaded 2024-02-27 | Repair queued |
| CMS-10500-SupportingStatement-B.docx |
Supporting Statement B | Uploaded 2024-02-23 | Repair queued |
 Attachment G - Response to Comments.pdf |
Supplementary Document | Uploaded 2024-02-23 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 216391 |  HOPDs/ASCs Patient Records |
Form and Instruction | Modified | |
| 216390 | National Implementation |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1240 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202107-0938-015 |
| Agency Tracking No | CM-CPC |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |