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Federal forms, ICRs, and supporting documents

Information Collection

Requirements for PACE Entities

IC 8559 under ICR 202405-0938-007 · OMB 0938-0790.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Requirements for PACE Entities
 
No Modified
 
Mandatory
 
42 CFR 460.82(f) 42 CFR 460.116(c) 42 CFR 460.120(b) and (e) 42 CFR 460.122(b) and (h) 42 CFR 460.124 42 CFR 460.156(a) and (b) 42 CFR 460.132(b) 42 CFR 460.152(b)(4) 42 CFR 460.190(a) 42 CFR 460.196(c) 42 CFR 460.104(c)(3)(iii) 42 CFR 460.201(a)(1) and (c)(1) 42 CFR 460.68(b)(1) and (2) 42 CFR 460.70(b)(1) 42 CFR 460.30(a) and (b) 42 CFR 460.72(a)(3) 42 CFR 460.71(a) 42 CFR 460.102(e)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction PACE Manual.docx https://www.cms.gov/Regulations-and- Guidance/Guidance/Manuals/Internet-Only-Manuals- IOMs-Items/CMS019036 No   Printable Only

Health Health Care Services

 

156 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 221,264 0 99,972 0 121,292 0
Annual IC Time Burden (Hours) 148,056 0 60,815 0 87,241 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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