Applicable GPO (Data Collection and Submission)

Registration, Attestation, Dispute Resolution and Correction, Assumptions Document and Data Retention Requirements for Open Payments (CMS-10495)

OMB: 0938-1237

IC ID: 238592

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

View Information Collection (IC)

Applicable GPO (Data Collection and Submission)
 
No Unchanged
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10495 Open Payments User Guide Open Payments User Guide_for_Reporting_Entities - 508 Compliant cf 1-31.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10495 General-Research-Ownership Submission Data Elements Screen Shots General-Research-Ownership Submission Data Elements 9.23.2020 - 508 new.pdf Yes Yes Fillable Fileable

Health Health Care Services

Open Payments - SOR# 09-70-0507  79 FR 108

23 0
   
Private Sector 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 48 0 0 0 0 48
Annual IC Time Burden (Hours) 306 0 0 0 0 306
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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