Information Collection

The Fiscal Soundness Reporting Requirements (CMS-906)

IC 8094 under ICR 202505-0938-006 · OMB 0938-0469.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-906 The Fiscal Soundness Reporting Requirements (CMS-906)	Form and Instruction
Form CMS-906 CMS-906 Collection Instrument and Instructions The Fiscal Soundness Reporting Requirements (CMS-906)	Form and Instruction
CMS-906 CMS-906 Collection Instrument and Instructions Collection Instrument and Instructions_11-15-2024.pdf	Form and Instruction
CMS-906 CMS-906 Collection Instrument and Instructions Collection Instrument and Instructions_11-15-2024.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 516(a)(5) 42 CFR 460.208 42 CFR 423.514 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-906				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,082

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,305	347	1,958
Annual IC Time Burden (Hours)	769	116	653
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.

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