View Information Collection (IC)

View Information Collection (IC)

#20: Payment Error Rate Measurement (PERM) Pilot
 
New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10398 (#20) CMS PERM – PETT 2.0 Round 1 Pilot Findings Submission User Guide Round 1 Findings Submission [rev 9-11-2014 by OSORA PRA].docx Yes Yes Fillable Printable
Form and Instruction CMS-10398 (#20) CMS PERM – PETT 2.0 Round 2 Pilot Proposal Submission User Guide Round 2 Proposal Submission [rev 9-11-2014 by OSORA PRA].docx Yes Yes Fillable Printable
Other-SHO Letter StateHealthOfficialLetter (3).pdf No   Printable Only

Health Health Care Services

 

52 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 52 0 52 0 0 0
Annual IC Time Burden (Hours) 1,120 0 1,120 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
#20 Supporting Statement: Payment Error Rate Measurement (PERM) Pilot #20 Supporting Statement - PERM Pilot Rounds 1 and 2 [Dec 2014].docx 12/23/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.