Information Collection Request

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

ICR 202607-0938-011 · OMB 0938-1289 · Received in OIRA

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
CMS-10569 Supporting Statement B EQRS CY 2027 (06-23-2026) .docx Supporting Statement B Uploaded 2026-07-20 Available
CMS-10569 Supporting Statement A EQRS CY 2027 (06-23-2026).docx Supporting Statement A Uploaded 2026-07-20 Available

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 04/30/2029
513,475 513,475
777,594 863,173
0 0





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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 ,  

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 513,475 513,475 0 0 0 0
Annual Time Burden (Hours) 777,594 863,173 0 -85,579 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


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