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Information Collection

Information Collection Requirements in Final Peer Review Organizations Sanction Regulations 42 CFR Sections 1004.40, 1004.50, 1004.60, 1004.70

IC 8053 under ICR 202412-0938-014 · OMB 0938-0444.

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

View Information Collection (IC)

Information Collection Requirements in Final Peer Review Organizations Sanction Regulations 42 CFR Sections 1004.40, 1004.50, 1004.50, 1004.60, 1004.70
 
No Modified
 
Mandatory
 
42 CFR 1004.40 42 CFR 1004.50 42 CFR 1004.70 42 CFR 1004.60

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-R-65 Sanctions Template Letter Sanctions Template Letter_09302024_CMS-R-65Final.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

34 0
   
Private Sector Not-for-profit institutions
 
   0 %

  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 34 0 16 0 0 18
Annual IC Time Burden (Hours) 8,144 0 3,428 0 0 4,716
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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