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

View Information Collection (IC)

Program Audits
 
No New
 
Mandatory
 
42 CFR 422.504 42 CFR 423.505 42 CFR 423.514

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Yes Yes Printable Only
Instruction Yes Yes Printable Only
Instruction Yes Yes Printable Only
Instruction Yes Yes Printable Only
Instruction Yes Yes Printable Only
Form CMS-10717 Yes Yes Fillable Printable
Form and Instruction CMS-10717 Yes Yes Fillable Printable
Form and Instruction CMS-10717 Yes Yes Fillable Printable
Form and Instruction CMS-10717 Yes Yes Fillable Printable
Form and Instruction CMS-10717 Yes Yes Fillable Printable
Instruction Yes Yes Printable Only
Form CMS-10717 Yes Yes Fillable Printable
Form and Instruction CMS-10717 Yes Yes Fillable Printable
Instruction Yes Yes Fillable Printable

Health Health Care Services

 

25 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 25 0 25 0 0 0
Annual IC Time Burden (Hours) 17,525 0 17,525 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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