Information Collection

QHP Issuers for the Appointment Wait Time Secret Shopper Data Collection

IC 266278 under ICR 202408-0938-010 · OMB 0938-1415.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1415 can be found here:

Documents and Forms

Document Name Document Type
CMS-10803 - AWT-SSS-Tech-Guide-QHP-FFE-508.pdf Appointment Wait Time Guidance IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	QHP Issuers for the Appointment Wait Time Secret Shopper Data Collection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 156.230(a)(2)(B)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 171	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: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	171	171
Annual IC Time Burden (Hours)	245,214	245,214
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appointment Wait Time Guidance	CMS-10803 - AWT-SSS-Tech-Guide-QHP-FFE-508.pdf	12/16/2024

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