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2021 > (PI Performance Category) Reweighting Applications for Promoting Interoperability and Other Performance Categories (see SS-A Table 16)
 
No Removed
 
Mandatory
 
42 CFR 414.1375

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10621 Hardship Exception Application Form Appendix K1 2020 Promoting Interoperability Hardship Exception Application.pdf Yes Yes Fillable Fileable
Form CMS-10621 Extreme and Uncontrollable Circumstances Application Form Appendix L1 2020 Extreme and Uncontrollable Circumstances Reweighting Application.pdf Yes Yes Fillable Fileable

Health Health Care Services

Quality Payment Program (QPP), System No. 09–70– 0539  83 FR 6587

52,099 30,620
   
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 -52,099 0 0 52,099
Annual IC Time Burden (Hours) 0 0 -13,025 0 0 13,025
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk - Hardship Exception Application Form Appendix K2 2020 Hardship Exception Application Form Crosswalk.pdf 01/05/2021
Crosswalk - Extreme and Uncontrollable Circumstances Application Form Appendix L2 2020 Extreme and Uncontrollable Circumstances Application Form CrossWalk.pdf 01/05/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.