OMB control number
Medicare Advantage Chronic Care Improvement Program (CCIP) Attestations (CMS-10209)
OMB 0938-1023 · HHS/CMS.
OMB 0938-1023
Section 1852(e) of the Social Security Act requires that MA organizations (MAOs) have an ongoing quality improvement program. CMS regulations at 42 CFR §422.152 outline the quality improvement program (QI Program) requirements for MA plans, which includes the development and implementation of both a Quality Improvement Project (QIP) and a Chronic Care Improvement Program (CCIP). The 2014 approved packaged reflected a process that required plans to report QIP and CCIP projects’ progress reports annually. This reinstatement package outlines the burden for the attestation process that reduces burden by requiring plans to attest annually that they have an ongoing CCIP that meets the requirements outlined at 42 CFR §422.152, rather than report annual progress reports. MA plans will only have to attest to having a CCIP once the proposed rule (CMS-4182-F; RIN 0938-AT08) that removes the QIP is final.
The latest form for Medicare Advantage Chronic Care Improvement Program (CCIP) Attestations (CMS-10209) expires 2021-12-31 and is listed under ICR 201804-0938-016.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
| Form | |
| Supporting Statement A | |
| Supplementary Document | |
| Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202106-0938-007 | Revision of a currently approved collection | 2021-06-17 | Approved with change | |
| 201804-0938-016 | Reinstatement with change of a previously approved collection | 2018-04-18 | Approved with change | |
| 201711-0938-009 | Reinstatement with change of a previously approved collection | 2017-11-29 | Comment filed on proposed rule | |
| 201404-0938-001 | Extension without change of a currently approved collection | 2014-04-08 | Approved without change | |
| 201111-0938-008 | Reinstatement with change of a previously approved collection | 2011-11-15 | Approved with change | |
| 201007-0938-016 | Extension without change of a currently approved collection | 2010-07-28 | Approved without change | |
| 200704-0938-012 | New collection (Request for a new OMB Control Number) | 2007-04-27 | Approved without change |
OMB Details
Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project
Federal Enterprise Architecture: Health - Health Care Services
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form CMS-10209 | CCIP Screen Shots -- Do Study Act Sections Annual Update | Fillable Printable | Form |
| Form CMS-10209 | QIP Screen Shots - Submission Screen Annual Update | Fillable Printable | Form |
| Form CMS-10209 | QIP Screen Shots - Study Section Annual Update | Fillable Printable | Form |
| Form CMS-10209 | QIP Screen Shots - Do Study Act Sections Annual Update | Fillable Printable | Form |
| Form CMS-10209 | QIP Screen Shots - Do Section Annual Update | Fillable Printable | Form |
| Form CMS-10209 | QIP Screen Shots - Contract Selection Screen Annual Update | Fillable Printable | Form |
| Form CMS-10209 | QIP Screen Shots - Act Section Annual Update | Fillable Printable | Form |
| Form CMS-10209 | CCIP Screen Shots - Submission Selection Screen Annual Update | CCIP Screen Shots - Submission Selection Screen Annual Update | Form |
| Form CMS-10209 | CCIP Screen Shots -- Do Section Annual Update | Fillable Printable | Form |
| Form CMS-10209 | CCIP Screen Shots - Contract Selection Screen Annual Update | Fillable Printable | Form |
| Form CMS-10209 | CCIP Screen Shots - Study Section Annual Update | Fillable Printable | Form |
| Form CMS-10209 | CCIP Screen Shots - Act Section Annual Update.jpg | Fillable Printable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.