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Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project
 
No Modified
 
Mandatory
 
42 CFR 422.152a 42 CFR 422.152(a)(1) and (2)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS 10209-CCIP Yes Yes Paper Only
Form and Instruction CMS 102-QIP Yes Yes Paper Only

Health Health Care Services

 

394 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved 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 788 0 0 -64 0 852
Annual IC Time Burden (Hours) 18,912 0 0 9,685 0 9,227
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
#3 07/09/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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