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Chronic Care Improvement Program and Medicare Advantage Quality Improvement Project
 
No Removed
 
Mandatory
 
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
Instruction 2014 CCIP User Guide.pdf No   Printable Only
Instruction 2014 QIP User Guide.pdf No   Paper Only
Form CMS-10209 CCIP Screen Shots - Act Section Annual Update.jpg CCIP Act Section Annual Update.jpg Yes Yes Fillable Printable
Form CMS-10209 CCIP Screen Shots - Contract Selection Screen Annual Update CCIP Contract Selection Screen Annual Update.jpg Yes Yes Fillable Printable
Form CMS-10209 CCIP Screen Shots -- Do Section Annual Update CCIP Do Section Annual Update.jpg Yes Yes Fillable Printable
Form CMS-10209 CCIP Screen Shots -- Do Study Act Sections Annual Update CCIP Do Study Act Sections Annual Update.jpg Yes Yes Fillable Printable
Form CMS-10209 CCIP Screen Shots - Study Section Annual Update CCIP Study Section Annual Update.jpg Yes Yes Fillable Printable
Form CMS-10209 CCIP Screen Shots - Submission Selection Screen Annual Update CCIP Submission Selection Screen Annual Update.jpg CCIP Screen Shots - Submission Selection Screen Annual Update Yes Yes Fillable Printable
Form CMS-10209 QIP Screen Shots - Act Section Annual Update QIP Act Section Annual Update.jpg Yes Yes Fillable Printable
Form CMS-10209 QIP Screen Shots - Contract Selection Screen Annual Update QIP Contract Selection Screen Annual Update.jpg Yes Yes Fillable Printable
Form CMS-10209 QIP Screen Shots - Do Section Annual Update QIP Do Section Annual Update.jpg Yes Yes Fillable Printable
Form CMS-10209 QIP Screen Shots - Do Study Act Sections Annual Update QIP Do Study Act Sections Annual Update.jpg Yes Yes Fillable Printable
Form CMS-10209 QIP Screen Shots - Study Section Annual Update QIP Study Section Annual Update.jpg Yes Yes Fillable Printable
Form CMS-10209 QIP Screen Shots - Submission Screen Annual Update QIP Submission Screen Annual Update.jpg Yes Yes Fillable Printable

Health Health Care Services

 

952 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 0 0 -1,904 0 0 1,904
Annual IC Time Burden (Hours) 0 0 -28,560 0 0 28,560
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk - CCIP User Guide PRA_CCIP_User_Guides_Crosswalk.xlsx 04/07/2014
Crosswalk - QIP User Guide PRA_QIP_User_Guides_Crosswalk.xlsx 04/07/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.