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§495.24(e) Objectives/Measures (hospitals/CAHs)

IC 216082 under ICR 202509-0938-006 · OMB 0938-1278.

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

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§495.24(e) Objectives/Measures (hospitals/CAHs)
 
No Unchanged
 
Mandatory
 
42 CFR 495.24

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10552 Attestation screen shots NG Attestation screen_(06-05-2024)_508_.pdf Yes Yes Fillable Fileable
Instruction HQR_User_Guide_(11-13-2023)_508.pdf Yes Yes Fillable Fileable
Form and Instruction cms-10552 Medicare Promoting Interoperability Program Hardship Exception Application hospital-hardship-form-pra-2025.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

4,550 2,331
   
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 4,550 0 0 0 0 4,550
Annual IC Time Burden (Hours) 30,151 0 0 0 0 30,151
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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