View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

: End-Stage Renal Disease Quality Incentive Program: Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10569 Letter to Facilities - data collection CMS_10569_CPM Request Letter to Facilities_template.docx Yes Yes Fillable Fileable
Instruction CMS_10569- Message Introducing Contractor to All Facilities_template.docx Yes Yes Fillable Fileable
Form and Instruction CMS-10569 EQRS Global App CMS-10569 screenshots 3-30-2020.docx Yes Yes Fillable Fileable

Health Health Care Services

ESRD Program Management and Medical Information System (PMMIS) published   74 FR 30606

7,695 958
   
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 511,957 0 4,120 0 0 507,837
Annual IC Time Burden (Hours) 967,280 0 -880,932 0 0 1,848,212
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.