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Medicare and Medicare Advantage Programs; Notification Procedures for Hospital Discharges : Important Message From Medicare (CMS-R-193)

IC 8309 under ICR 201607-0938-009 · OMB 0938-0692.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
Information Collection (IC) Details

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Medicare and Medicare Advantage Programs; Notification Procedures for Hospital Discharges : Important Message From Medicare (CMS-R-193)
 
No Modified
 
Mandatory
 
42 CFR 422.620 42 CFR 405.1205

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-R-193 Important Message from Medicare IM2016v508.pdf No   Paper Only
Form and Instruction CMS-R-193 Mensaje Importante De Medicare Sobre Sus Derechos SpanishIMv508.pdf No   Paper Only

Health Health Care Services

 

6,142 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  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 23,680,000 0 0 3,840,000 0 19,840,000
Annual IC Time Burden (Hours) 3,404,000 0 0 428,000 0 2,976,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk CrosswalkIM2016 [rev July 2016].pdf 07/18/2016
IM (English) Track Changes IM2016trackchanges.docx 07/18/2016
IM (Spanish) Track Changes SpanishIM2016trackchanges.docx 07/18/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.