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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)
Modified
5011
835
0
42 CFR 495.10(a)-(c) -- (EPs) (2011) average
Modified
521600
86933
0
42 CFR 495.10(d) - (EPs) (2012) average
Modified
57998
9666
0
42 CFR 495.10(d) - (hospital) (2012)
Modified
401
67
0
42 CFR 495.10(e)(1) - (EPs) (2011) average
Modified
95500
15917
0
42 CFR 495.10(e)(2) - (EPs) (2012) average
Modified
96500
16083
0
42 CFR 495.202(b)(2) (2012) EPs-final ID
Modified
12
2
0
42 CFR 495.202(b)(2) (2012) EPs-preliminary ID
Modified
12
2
0
42 CFR 495.202(b)(2) (2012) MA-affiliated hospitals-final ID
Modified
12
1
0
42 CFR 495.202(b)(2) (2012) MA-affiliated hospitals-preliminary ID
Modified
12
1
0
42 CFR 495.204(b)(2) (2012) Revenue reporting
Modified
12
160
0
42 CFR 495.204(b)(4) (2012) EPs-method
Modified
2
1
0
42 CFR 495.204(b)(5) or (b)(6)(2012) EPs-salary
Modified
12
233
0
42 CFR 495.210(b) (2012) EPs-attestation
Modified
12
160
0
42 CFR 495.306(a)(1)(i)
Modified
139600
23267
0
42 CFR 495.306(a)(1)(ii)(A)
Modified
139600
23267
0
42 CFR 495.306(a)(1)(ii)(B)
Modified
139600
23267
0
42 CFR 495.306(a)(2)
Modified
4933
822
0
42 CFR 495.316
Modified
56
93
0
42 CFR 495.330(a) - average
Modified
56
93
0
42 CFR 495.348(c)
Modified
56
9
0
42 CFR 495.348(e)
Modified
56
9
0
42 CFR 495.348(f)
Modified
56
93
0
42 CFR 495.350--average
Modified
56
19
0
42 CFR 495.352 -- average
Modified
56
93
0
42 CFR 495.366 -- average
Modified
56
93
0
42 CFR 495.8 (a)(1)- EHR Technology Used, Core Set Objectives/Measures & Quality Measures (EPs) (2011)
Modified
521600
1628609
0
42 CFR 495.8 (a)(1)- Menu Set Objectives/Measures average (EPs) (2011)
Modified
521600
292617
0
42 CFR 495.8 (a)(2)- Ambulatory Quality Measures (EPs) (2012)
Modified
527254
87876
0
42 CFR 495.8 (a)(2)- Menu Set Objectives/ Measures average (EPs) (2012)
Modified
527254
295789
0
42 CFR 495.8 (b)(1)-- EHR Technology Used, Core Set Objectives/Measures & Quality Measures (hospitals/CAHs) (2011)
Modified
5011
23050
0
42 CFR 495.8 (b)(2)- Hospital Quality Measures (hospitals/CAHs) (2012)
Modified
5011
835
0
42 CFR 495.8 (b)(2)- Menu Set Objectives/ Measures average (hospitals/CAHs) (2012)
Modified
5011
3508
0
42 CFR 495.8 (b)(2)-- EHR Technology Used & Core Set Objectives/Measures (hospitals/CAHs) (2012)
Modified
5011
14532
0
42 CFR 495.8(a)(2) - EHR Technology Used & Core Set Objectives/Measures (EPs) (2012)
Modified
527254
1558387
0
42 CFR 495.8(b)(1) - Menu Set Objectives/ Measures average (hospitals/CAHs) (2011)
Modified
5011
3058
0
495.210 - Attesting on behalf of MA EPs
New
13000
1083
0
495.210 - Attesting on behalf of MA-affiliated hospitals
New
30
15
0
495.210 - Gather information for attestation (MA EPs)
New
13000
3250
0
495.210 - Gather information for attestation (MA-affiliated hospitals)
New
30
70
0
495.210 - Total Cost of Attestation for Stage 2 (MA EPs)
New
13000
4333
0
495.210 - Total cost of attestation for Stage 2 (MA-affiliated hospitals)
New
30
85
0
495.342 - Frequency of Health Information Technology (HIT) Implementation Advanced Planning Document (IAPD) Updates
New
56
1307
0
495.6 - EHR Technology Used, Core Set Objectives/Measures (Hospitals/CAHS)
New
2696
6965
0
495.6 - Menu Set Objectives/Measures (EPs) average
New
198912
18234
0
495.6 - Menu Set Objectives/Measures (Hospitals/CAHs)
New
2696
449
0
495.6 EHR Technology Used, Core Set Objectives/Measures (EPs)
New
198912
545019
0
495.8 - CQMs for hospitals/CAHS
New
2696
2399
0
495.8 - CQMs for hospitals/CAHs
New
198912
99456
0
Total burden requested under this ICR:
4495264
4792112
0
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