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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Quality Measures and Procedures for Hospital Reporting of Quality Data
Unchanged
17600
6050000
0
Form and Instruction
CMS-10210
Data Accuracy and Completeness Acknowledgemenmt
Form and Instruction
CMS-10210
HVBP Review and Corrections Form
Form and Instruction
CMS-10210
HVBP Appeal Request Form
Form and Instruction
CMS-10210
Validation Template CAUTI
Form and Instruction
CMS-10210
Validation Template MRSA
Form and Instruction
CMS-10210
Validation Template CLABSI
Form and Instruction
CMS-10210
Validation Template CDI
Form and Instruction
CMS-10210
Request for Withholding Data from Public Reporting
Form and Instruction
CMS-10210
Reconsideration Request Form electronic
Form and Instruction
CMS-10210
Extroadinary Circumstances Disaster Waiver
Form and Instruction
CMS-10210
Healthcare Associated Infection Exception Form
Form and Instruction
CMS-10210
HVBP Appeal Request Form Screen Shot
Form and Instruction
CMS-10210
HVBP Review and Correction Rquest Form Screen Shot
Form and Instruction
CMS-10210
HIQR Notice of Participation Form
Form and Instruction
CMS-10210
Reconsideration Request Form
Total burden requested under this ICR:
17600
6050000
0
To view an IC, click on IC Title