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 Modified 17600 7968928 0 Form and Instruction CMS-10210 Data Accuracy and Completeness Form
Form and Instruction CMS-10210 Hospital VPB Review and Corrections Form
Form and Instruction CMS-10210 Extraordinary Circumstances Form
Form and Instruction CMS-10210 Inpatient Withholding Data form
Form and Instruction CMS-10210 IQR Measure Exception Form
Form and Instruction CMS-10210 IQR Notice of Participation Form
Form and Instruction CMS-10210 IQR Reconsideration Request Form
Form and Instruction CMS-10210 CAUTI Validation Template
Form and Instruction CMS-10210 CDI Validation Template
Form and Instruction CMS-10210 CLABSI Validation Template
Form and Instruction CMS-10210 MRSA Validation Template
Form and Instruction CMS-10210 Validation Review for Reconsideration Request
Form and Instruction CMS-10210 VBP Appeal Request Form
Total burden requested under this ICR: 17600 7968928 0  
To view an IC, click on IC Title