Information Collection Request

Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network (CROWNWeb) (CMS-10569)

ICR 202508-0938-009 · OMB 0938-1289 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10569 EQRS Global App Form and Instruction Modified Available
Form CMS-10569 Letter to Facilities - data collection Form and Instruction Modified Available
Form CMS-10569 : End-Stage Renal Disease Quality Incentive Program: Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network Form and Instruction Modified Available
CMS-10569 Supporting Statement A EQRS CY 2026 (07-17-2025).docx Supporting Statement A Uploaded 2025-08-06 Repair queued
CMS-10569 Supporting Statement A EQRS CY 2026 (07-17-2025).docx Supporting Statement A Uploaded 2025-08-06 Repair queued
CMS-10569 Supporting Statement B EQRS CY 2026 (07-17-2025).docx Supporting Statement B Uploaded 2025-08-06 Available
CMS-10569 Supporting Statement B EQRS CY 2026 (07-17-2025).docx Supporting Statement B Uploaded 2025-08-06 Missing upstream

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2027 36 Months From Approved 01/31/2027
511,957 0 511,957
967,280 0 967,280
0 0 0





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table that charts list of burden
IC Title Form No. Form Name
: End-Stage Renal Disease Quality Incentive Program: Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network CMS-10569, CMS-10569 ,  



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  No