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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
42 CFR 495.10(a) (b) (hospital) (2011)
New
5011
2506
0
42 CFR 495.10(a)-(c) -- (EPs) (2011) average
New
521600
260800
0
42 CFR 495.10(d) - (EPs) (2012) average
New
57998
28999
0
42 CFR 495.10(d) - (hospital) (2012)
New
401
201
0
42 CFR 495.10(e)(1) - (EPs) (2011) average
New
95500
47750
0
42 CFR 495.10(e)(2) - (EPs) (2012) average
New
96500
48250
0
42 CFR 495.202(b)(2) (2012) EPs-final ID
New
12
6
0
42 CFR 495.202(b)(2) (2012) EPs-preliminary ID
New
12
6
0
42 CFR 495.202(b)(2) (2012) MA-affiliated hospitals-final ID
New
12
3
0
42 CFR 495.202(b)(2) (2012) MA-affiliated hospitals-preliminary ID
New
12
3
0
42 CFR 495.204(b)(2) (2012) Revenue reporting
New
12
480
0
42 CFR 495.204(b)(4) (2012) EPs-method
New
2
3
0
42 CFR 495.204(b)(5) or (b)(6)(2012) EPs-salary
New
12
700
0
42 CFR 495.210(b) (2012) EPs-attestation
New
12
480
0
42 CFR 495.306(a)(1)(i)
New
139600
69800
0
42 CFR 495.306(a)(1)(ii)(A)
New
139600
69800
0
42 CFR 495.306(a)(2)
New
4933
2467
0
42 CFR 495.316
New
56
280
0
42 CFR 495.330(a) - average
New
56
280
0
42 CFR 495.348(c)
New
56
28
0
42 CFR 495.348(e)
New
56
28
0
42 CFR 495.348(f)
New
56
280
0
42 CFR 495.350--average
New
56
56
0
42 CFR 495.352 -- average
New
56
280
0
42 CFR 495.366 -- average
New
56
280
0
42 CFR 495.8 (a)(1)- EHR Technology Used, Core Set Objectives/Measures & Quality Measures (EPs) (2011)
New
521600
4885827
0
42 CFR 495.8 (a)(1)- Menu Set Objectives/Measures average (EPs) (2011)
New
521600
877853
21700000000
42 CFR 495.8 (a)(2)- Menu Set Objectives/ Measures average (EPs) (2012)
New
527254
887368
4500000000
42 CFR 495.8 (a)(2)- Ambulatory Quality Measures (EPs) (2012)
New
527254
263627
0
42 CFR 495.8 (b)(1)-- EHR Technology Used, Core Set Objectives/Measures & Quality Measures (hospitals/CAHs) (2011)
New
5011
46101
0
42 CFR 495.8 (b)(2)- Hospital Quality Measures (hospitals/CAHs) (2012)
New
5011
2506
0
42 CFR 495.8 (b)(2)- Menu Set Objectives/ Measures average (hospitals/CAHs) (2012)
New
5011
10523
5000000000
42 CFR 495.8 (b)(2)-- EHR Technology Used & Core Set Objectives/Measures (hospitals/CAHs) (2012)
New
5011
43596
0
42 CFR 495.8(a)(2) - EHR Technology Used & Core Set Objectives/Measures (EPs) (2012)
New
527254
4675161
0
42 CFR 495.8(b)(1) - Menu Set Objectives/ Measures average (hospitals/CAHs) (2011)
New
5011
10523
20600000000
42CFR495.306(a)(1)(ii)(B)
New
139600
69800
0
Total burden requested under this ICR:
3851294
12306651
51800000000
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