?495.24(e) Objectives/Measures (hospitals/CAHs)

Implementation of Medicare Programs; - Medicare Promoting Interoperability Program (CMS-10552)

Documents and Forms

Document Name Document Type
Form CMS-10552 ?495.24(e) Objectives/Measures (hospitals/CAHs) Form and Instruction
HQR_User_Guide_(11-13-2023)_508.pdf Instruction
CMS-10552 Attestation screen shots NG Attestation screen_(06-05-2024)_508_.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	§495.24(e) Objectives/Measures (hospitals/CAHs)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 495.24

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10552	Attestation screen shots	NG Attestation screen_(06-05-2024)_508_.pdf		Yes	Yes	Fillable Fileable
Instruction			HQR_User_Guide_(11-13-2023)_508.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,550	Number of Respondents for Small Entity: 2,331

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	4,550	50	4,500
Annual IC Time Burden (Hours)	30,151	526	29,625
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.