Information Collection

CCW VRDC Stakeholder Engagement Plan (CMS-10880)

IC 283054 under ICR 202610-0938-001 · OMB 0938-1185.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10880 VRDC Survey Questions CCW VRDC Stakeholder Engagement Plan (CMS-10880)	Form and Instruction
Form CMS-10880 Focus Group Session Moderator Guide Script CCW VRDC Stakeholder Engagement Plan (CMS-10880)	Form and Instruction
CMS-10880 VRDC Survey Questions CCW VRDC Survey Questions (FINAL) 2023-11-27.docx	Form and Instruction
CMS-10880 Focus Group Session Moderator Guide Script CCW VRDC Focus Group Guide (FINAL) 2023-11-27.docx	Form and Instruction
CMS-10880_FastTrack_SupportingStatement_.docx CMS-10880.Fast Track Generic Supporting Statement	IC Document

IC Title:

Agency IC Tracking Number:

OEDA

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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-10880				Yes	Yes	Fillable Fileable
Form and Instruction	CMS-10880				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,620

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,620	1,620
Annual IC Time Burden (Hours)	615	615
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CMS-10880.Fast Track Generic Supporting Statement		10/14/2026

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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