OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Health Care Provider Feedback on Open Payments National Transparency Program (Open Payments) - (CMS-10826)

IC 283015 under ICR 202610-0938-001 · OMB 0938-1185.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form CMS-10826
CMS-10826.Recruitment Guide – Teaching Hospital Representatives Health Care Provider Feedback on Open Payments National Transparency Program (Open Payments) - (CMS-10826)		 Form and Instruction
Form CMS-10826
CMS-10826.Recruitment Guide for Physicians and Other Health Care Providers Health Care Provider Feedback on Open Payments National Transparency Program (Open Payments) - (CMS-10826)		 Form and Instruction
Form CMS-10826
CMS-10826.Health Care Providers (Primary Care and Specialist) Health Care Provider Feedback on Open Payments National Transparency Program (Open Payments) - (CMS-10826)		 Form and Instruction
Form CMS-10826
CMS-10826.Users-Checked Data (Physicians and Teaching Hospitals) (revised) Health Care Provider Feedback on Open Payments National Transparency Program (Open Payments) - (CMS-10826)		 Form and Instruction
CMS-10826 CMS-10826.Recruitment Guide – Teaching Hospital Represen
CMS-10826.Recruitment Guide – Teaching Hospital Representatives (revised).docx 		Form and Instruction
CMS-10826 CMS-10826.Recruitment Guide for Physicians and Other Hea
CMS-10826.Recruitment Guide for Physicians and Other Health Care Providers (revised).docx 		Form and Instruction
CMS-10826 CMS-10826.Health Care Providers (Primary Care and Specia
CMS-10826.Health Care Providers (Primary Care and Specialist).docx 		Form and Instruction
CMS-10826 CMS-10826.Users-Checked Data (Physicians and Teaching Ho
CMS-10826.Users-Checked Data (Physicians and Teaching Hospitals) (revised).docx 		Form and Instruction
CMS-10826. Database Examples (supplementary) (revised).docx
CMS-10826. Database Examples (supplementary) (revised)		IC Document
CMS-10826. Generic Clearance Supporting Statement - Providers (revised).docx
CMS-10826. Generic Clearance Supporting Statement - Providers (revised)		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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-10826 Yes No Fillable Fileable
Form and Instruction CMS-10826 Yes No Fillable Fileable
Form and Instruction CMS-10826 Yes No Fillable Fileable
Form and Instruction CMS-10826 Yes No Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested 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 138 0 138 0 0 0
Annual IC Time Burden (Hours) 44 0 44 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
CMS-10826. Database Examples (supplementary) (revised) 10/13/2026
CMS-10826. Generic Clearance Supporting Statement - Providers (revised) 10/13/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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