Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Application and Re-application processes Modified 30 3800 0 Form and Instruction CMS-10394 Application
Form and Instruction CMS-10394 QECP Measure Production QA Worksheet
Form and Instruction CMS-10394 QECP Measure Information Workbook
Instruction
Form and Instruction CMS-10394 QECP Phase 1 Data Source Attestation Requirements
Form and Instruction CMS-10394 Qualified Entity Certification Program Data Security Review (QECP DSR)
Form and Instruction CMS-10394 Letter of Commitment Template
Instruction
Total burden requested under this ICR: 30 3800 0  
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