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Centers for Medicare & Medicaid Services

Agency prefix 0938 · CMS · Federal forms and information collections.

Forms
OMB NumberTitle
0938-1487 Medicare Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey (CMS-10931)
0938-1486 Supplemental to Form CMS-2552-10: Weighted Median Medicare Advantage Organization Payer- Specific Negotiated Charge Data (CMS-10935)
0938-1485 [IRA Collection] Medicare Prescription Drug Inflation Rebate Program: Sections 11101 and 11102 of the Inflation Reduction Act (IRA) (CMS-10930)
0938-1484 Accreditation of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers (CMS-10932)
0938-1476 Generic Collections for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398 Part II)
0938-1475 The Medicare Advantage and Prescription Drug Programs: Part C and Part D Medicare Prescription Payment Plan Model Documents (CMS-10882) - IRA
0938-1474 Rebate Reduction Requests underSections 11101 and 11102 of the Inflation Reduction Act (CMS-10858) - IRA
0938-1473 Supplemental to Form CMS-2552-10 Payment Adjustment for Establishing and Maintaining Access to Buffer Stock of Essential Medicines (CMS-10897)
0938-1472 Quality Measures and Administrative Procedures for the Skilled Nursing Facility Value-Based Purchasing Program and Quality Reporting Program for the FY 2025 SNF PPS Proposed Rule (CMS-10895)
0938-1471 ADA Dental Claim Form (CMS-10883)
0938-1470 Patient Provider Dispute Resolution Requirements Related to Surprise Billing: Part II (CMS-10853)
0938-1468 The Medicare Advantage and Prescription Drug Programs: Part C and Part DMedicare Advantage Prescription Drug (MARx) System Updates for the Medicare Prescription Payment Plan Program (CMS-10887 - IRA
0938-1467 Medicare Change of Status Notice (MCSN) (CMS-10868)
0938-1466 Retrospective Appeal Requests (CMS-10885)
0938-1465 Part D Drug Management Program (CMS-10874)
0938-1464 Medicare Health Outcomes Survey Field Test (CMS-10861)
0938-1463 Supporting Statement for Direct Enrollment Entities (CMS-10877)
0938-1462 Reporting Requirements and Corrective Action Plans Under Section 1902(tt) of the Social Security Act (CMS-10875)
0938-1461 Non-Standardized Plan Option Limit Exception Justification Form (CMS-10878)
0938-1460 Special Requirements for Rural Emergency Hospitals (REHs) (CMS-10863)
0938-1459 Generic Clearance for CMS and Medicare Administrative Contractor (MAC)Generic Customer Experience (CMS-10731)
0938-1458 Ambulatory Surgical Center (ASC) Covered Procedure List (CPL) Pre-Proposed Rule Recommendation Request (CMS-10809)
0938-1457 CMS Health Equity Award – Call for Nominations (CMS-10866)
0938-1456 Medicare Plan Performance Warning Information (CMS-10836)
0938-1455 Requirement for Electronic Prescribing for Controlled Substances (EPCS) for a Covered Part D Drug Under a Prescription Drug Plan or an MA–PD Plan (CMS-10834)
0938-1454 Rural Emergency Hospital Quality Reporting (REHQR) (CMS-10870)
0938-1453 [Medicaid] Medicaid Managed Care and Supporting Regulations (CMS-10856)
0938-1452 Drug Price Negotiation Process under Sections 11001 and 11002 of the Inflation Reduction Act (CMS-10849) - (IRA)
0938-1451 Medicare Part D Manufacturer Discount Program Agreement - IRA (CMS-10846)
0938-1450 End-stage Renal Disease (ESRD) Quality Incentive Program (QIP): Study of Quality and Patient Experience (CMS-10823)
0938-1449 Negotiation Data Elements under Sections 11001 and 11002 of the Inflation Reduction Act (CMS-10847)
0938-1448 Payment Adjustment for Low-Volume Hospitals Under the Hospital Inpatient Prospective Payment System (IPPS) (CMS-10857)
0938-1447 Medicare Disproportionate Share Hospital (DSH) Payments: Counting Days Associated With Section 1115 Demonstrations in the Medicaid Fraction (CMS-10839)
0938-1446 List of Screening Instruments for Housing Stability, Food Security, and Transportation Questions on Health Risk Assessments (HRAs) and Requirements for Integrated HRAs (CMS-10825)
0938-1445 [Medicaid] Medicaid Managed Care and Supporting Regulations (CMS-10855)
0938-1444 Annual Notice of Change and Evidence of Coverage for Applicable Integrated Plans in States that Require Integrated Materials (CMS-10824)
0938-1443 Small Biotech Exception and Biosimilar Delay Information Collection Request for Initial Price Applicability Year 2027 (CMS-10844) - IRA
0938-1442 Medicare Advantage and Prescription Drug Program: Communications and Marketing Provisions (CMS-10837)
0938-1441 Transitional Coverage and Retroactive Medicare Part D Coverage for Certain Low-Income Beneficiaries through the Limited Income Newly Eligible Transition (LI NET) Program (CMS-10831)
0938-1440 Medicare Part C and Medicare Part D Enrollment Form Interviews (CMS-10816)
0938-1439 Improper Payment Pre-Testing and Assessment (IPPTA) (CMS-10829)
0938-1438 Supporting Statement for Agent/Broker Consent Information Collection (CMS-10840)
0938-1437 Advancing Interoperability and Improving Prior Authorization Processes (CMS-10843)
0938-1436 Customer Satisfaction Survey for Enterprise Portal Services (EPS) Users (CMS-10789)
0938-1435 Dispute Resolution for Discarded Drug Refunds (CMS-10835)
0938-1434 Patient-Reported Indicator Survey (PaRIS) (CMS-10792)
0938-1433 Requirements Related to Surprise Billing; Part II (CMS-10791)
0938-1432 Medicare Advantage and Prescription Drug Plan Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey Field Test (CMS-10793)
0938-1431 Medicare Severity Diagnosis Related Groups Reclassification Request (MS-DRGs) (CMS-10775)
0938-1430 SUPPORT for Patients and Communities Act Section 1003 Demonstration Evaluation (CMS-10786)
0938-1429 Transparency in Pricing Information (CMS-10715)
0938-1428 Application for Enrollment in Part B Immunosuppressive Drug Coverage (Part B-ID) (CMS-10798)
0938-1427 National Plan and Provider Enumeration System (NPPES) Supplemental Data Collection (CMS-10749)
0938-1426 Application For Medicare Part A and Part B Special Enrollment Period - Exceptional Circumstances (CMS-10797)
0938-1425 Supplemental to Form CMS-2552-10, Payment Adjustment for Domestic NIOSH-Approved Surgical N95 Respirators (CMS-10821)
0938-1424 Evaluation of the CMS Network of Quality Improvement and Innovation Contractors Program (NQIIC) (CMS-10769)
0938-1423 Transparency in Pricing Information (CMS-10715)
0938-1422 D-SNP Enrollee Advisory Committee and SNP Standardized Questions on Health Risk Assessments (CMS-10799)
0938-1421 Medicare Advantage, Section 1876 Cost Plans, and Prescription Drug Program: Notification of Free Interpreter Services (CMS-10802)
0938-1420 Pre-Claim Review Demonstration for Inpatient Rehabilitation Facility Services (CMS-10765)
0938-1419 FOIA/Privacy Act Requests for Medicare Claims Data via CMS FOIA Public Portal (CMS-10781)
0938-1418 The ESRD Network Peer Mentoring Program (CMS-10768)
0938-1417 Medicare-Funded GME Residency Positions in accordance with Section 126 of the Consolidated Appropriations Act, 2020 (Public Law 116-93) (CMS-10790)
0938-1416 Estimation of Improper Payments of the Advanced Payment of Premium Tax Credit (APTC) in State Exchanges under the Affordable Care Act (CMS-10794)
0938-1415 Essential Community Provider-Network Adequacy (ECP/NA) Data Collection to Support QHP Certification (CMS-10803)
0938-1414 Omnibus COVID-19 Health Care Staff Vaccination (IFC) (CMS-10801)
0938-1413 Medicare Beneficiary Experiences with Care Survey (MBECS) System (CMS-10701)
0938-1412 Patient Access Through Application Programming Interfaces (API) (CMS-10767)
0938-1411 Data Management Plan Self-Attestation Questionnaire (DMPSAQ) (CMS-10733)
0938-1410 Dual Eligible Special Needs Plan Contract with the State Medicaid Agency (CMS-10796)
0938-1409 The International Classification of Diseases, 10th Revision, Procedure Coding System (ICD–10–PCS) (CMS-10774)
0938-1408 Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program – Contracting Forms (CMS-10744)
0938-1407 Prescription Drug Data Collection (RxDC) Reporting Instructions
0938-1406 Complaints Submission Process under the No Surprises Act (CMS-10779)
0938-1405 Prescription Drug and Health Care Spending (CMS-10788)
0938-1404 The Home Health Care CAHPS® Survey (HHCAHPS) Mode Experiment (CMS-10784)
0938-1403 Agent and Broker Disclosure and Reporting Requirements (CMS-10787)
0938-1402 Conditions of Participation for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID) (CMS-10777)
0938-1401 Requirements Related to Surprise Billing: Qualifying Payment Amount, Notice and Consent, Disclosure on Patient Protections Against Balance Billing, and State Law Opt-in (CMS-10780)
0938-1400 Evaluation of Risk Adjustment Data Validation (RADV) Appeals and Health Insurance Exchange Outreach Training Sessions (CMS-10764)
0938-1399 Quality Payment Program/Merit-Based Incentive Payment System (MIPS) Surveys and Feedback Collections (CMS-10695)
0938-1398 Accrediting Organization use of CMS Online Hospice Basic Training (CMS-10778)
0938-1397 Generic Clearance for the Center for Clinical Standards and Quality IT Product and Support Teams (CMS-10706)
0938-1396 Medicare Part D Electronic Prescribing Tools (42 CFR 423.128(d)(4)-(5) and 423.160(b)(1)) (CMS-10755)
0938-1395 Medicare Part C and Part D Program Audit and Industry-Wide Part C Timeliness Monitoring Project (TMP) Protocols (CMS-10717)
0938-1394 Pharmacy Benefit Manager Transparency (CMS-10725)
0938-1393 Non-Quantitative Treatment Limitation Analyses and Compliance Under MHPAEA (CMS-10773)
0938-1392 Electronic Medical Documentation Interoperability (EMDI) Pre and Post Pilot Measures Survey (CMS-10714)
0938-1391 CLIA Collection of Information Requirements Related to SARS-CoV-2 Test Results Reporting (CMS-10757)
0938-1390 Administrative Simplification HIPAA Compliance Review (CMS-10662)
0938-1389 Review and Approval Process for Waivers for State Innovation (CMS-10383)
0938-1388 Value in Opioid Use Disorder Treatment Demonstration (CMS-10728)
0938-1387 Medicare Coverage of Items and Services for Coverage with Evidence Development (CMS-10697)
0938-1386 Applicable Integrated Plan Coverage Decision Letter (CMS-10716)
0938-1385 [Medicaid] Annual State Report on Value Based Purchasing Arrangements (VBP) Supplemental Rebate Agreements (CMS-10722)
0938-1384 Submissions of 1135 Waiver Request Automated Process (CMS-10752)
0938-1383 Program Integrity Portal FWA Reporting Module - Part C Plans (CMS-10724)
0938-1382 Generic Clearance for Improving Customer Experience: OMB Circular A–11, Section 280 Implementation) (CMS-10710)
0938-1381 Collection of Premium Credit Adjustment Data Related to COVID-19 Emergency (CMS-10751)
0938-1380 Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Model Process and Requirements (CMS-10708)
0938-1379 Medicare Current Beneficiary Survey (MCBS) COVID-19 Rapid Response Supplement (CMS-P-0015A)
0938-1378 Model Medicare Advantage and Medicare Prescription Drug Plan Individual Enrollment Request Form (CMS-10718)
0938-1377 Medicare Enrollment Application for Clinics/Group Practices and Other Suppliers (CMS-855B)
0938-1376 Temporary Extraordinary Circumstances Exception for Excepted Provider-Based Departments (CMS-10730)
0938-1375 Excepted Benefit Health Reimbursement Arrangements
0938-1374 Hospital Survey for Specified Covered Outpatient Drugs (SCODs) (CMS-10709)
0938-1373 Accrediting Organization Change of Ownership Requirements (CMS-10705)
0938-1372 Transparency in Pricing Information (CMS-10715)
0938-1371 Data Request and Attestation for PDP Sponsors (CMS-10691)
0938-1370 Testing of Web Survey Design and Administration for CMS Experience of Care Surveys (CMS-10694)
0938-1369 Requirements for Hospitals to Make Public a List of Their Standard Charges (CMS-10707)
0938-1368 Proposed Prior Authorization Process and Requirements for Certain Hospital Outpatient Department (OPD) Services (CMS-10711)
0938-1367 Religious Nonmedical Health Care Institutions (RNHCIs) Conditions of Participation and Supporting Regulations (CMS-10712)
0938-1366 Information Collection Requirements Contained in the State Flexibility to Stabilize the Market Grant Program (CMS-10657)
0938-1365 Information Collection Requirement for Mid-Year Formulary Change Reporting and Notice Requirement (CMS-10696)
0938-1364 Home Health (HH) National Provider Survey (CMS-10688)
0938-1363 Reform of Requirements for Long-Term Care Facilities (CMS-10573)
0938-1362 Home and Community Based Services (HCBS) Incident Management Survey (CMS-10692)
0938-1361 Health Reimbursement Arrangements and Other Account-Based Group Health Plans (CMS-10704)
0938-1360 Electronic Visit Verification (EVV) Compliance Survey (CMS-10680)
0938-1359 21st Century Cures Act Section 12002 IMD Study (CMS-10684)
0938-1358 Supporting Statement for Billing and Collection of the Separate Payment for Certain Abortion Services (CMS-10681)
0938-1357 CLIA Proficiency Testing (PT) (CMS-10690)
0938-1356 Evaluation of the CMS Quality Improvement Organizations: Medication Safety and Adverse Drug Event Prevention (CMS-10675)
0938-1355 Medicare Enrollment Application for Physician and Non-Physician Practitioners; (CMS-855i)
0938-1354 Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration (CMS-10673)
0938-1353 Marketplace Operations (CMS-10637)
0938-1352 Quality Measures and Administrative Procedures for the Hospital-Acquired Condition Reduction Program for the FY 2019 IPPS Program Year (CMS-10668)
0938-1351 Limited Wraparound Coverage Reporting (CMS-10571)
0938-1350 CMS Tribal Long Term Services and Supports (LTSS) Program Survey
0938-1349 State Permissions for Enrollment in Qualified Health Plans in the Federally Facilitated Exchange & Non-Exchange Entities (CMS-10650)
0938-1348 QIC Demonstration Evaluation Contractor (QDEC): Analyze Medicare Appeals to Conduct Formal Discussions and Reopenings with Suppliers
0938-1347 PRA for the Add-On Payments for New Medical Services and Technologies Policy(CMS-10638)
0938-1346 Triennial Network Adequacy Review for Medicare Advantage Organizations and 1876 Cost Plans (CMS-10636)
0938-1345 Appropriate Use Criteria (AUC) for Diagnostic Imaging Services: Consultation of Specified Applicable AUC through a Qualified Clinical Decision Support Mechanism (CDMS) (CMS-10654)
0938-1344 Coverage of Certain Preventive Services Under the Affordable Care Act (CMS-10653)
0938-1343 Virtual Groups for Merit-Based Incentive Payment System (MIPS) (CMS-10652)
0938-1342 Evaluating Coverage to Care in Communities (CMS-10632)
0938-1341 Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers (CMS-10592)
0938-1340 National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) (CMS-10639)
0938-1339 Evaluating a Pilot Mobile Health Program (CMS-10634)
0938-1338 De Minimis for LIS Individuals and Uniform Exceptions and Appeals Process for Prescription Drug Plans and MA-PD Plans
0938-1337 Changes to Close the Part D Coverage Gap, Improvements to MTM Programs, Independence of LTC Consultant Pharmacists
0938-1336 Agent Broker Training Requirements
0938-1335 Notification of Involuntary Disenrollment by the Centers for Medicare & Medicaid Services for Failure to Pay the Part D Income Related Monthly Adjustment Amount
0938-1334 Credentialing and Privileging Process for Physicians and Practitioners Providing Telemedicine Services
0938-1333 The Medicare Advantage and Prescription Drug Program: Customized Enrollee Data
0938-1332 Montana Health and Economic Livelihood Partnership (HELP) Federal Evaluation (CMS-10635)
0938-1331 Clearance for Evaluation of Stakeholder Training Health Insurance Marketplace and Market Stabilization Programs (CMS-10598)
0938-1330 (CMS-10622) Evaluation of the CMS Quality Improvement Organizations: Reducing Healthcare-Acquired Conditions in Nursing Homes
0938-1329 Information Collection Requirements for Non-Exchange Entities (CMS-10666)
0938-1328 Initial Request for State Implemented Moratorium Form (CMS-10628)
0938-1327 The PACE Organization (PO) Monitoring and Audit Process in Part 460 of 42 CFR (CMS-10630)
0938-1326 The PACE Organization Application Process in 42 CFR Part 460 (CMS-10631)
0938-1325 (CMS-10578) Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers
0938-1324 Testing Experience and Functional Tools Demonstration: Personal Health Record (PHR) User Survey (CMS-10623)
0938-1323 Medicare Program; Reporting and Returning of Overpayments (CMS-10405)
0938-1322 CMS Healthcare.gov Site Wide Online Survey
0938-1321 Information Collection Requirements for Non-Exchange Entities (CMS-10633)
0938-1320 The Health Insurance Enforcement and Consumer Protections Grant Program (CMS-10605)
0938-1319 [Medicaid] Medicaid Program Face-to-Face Requirements for Home Health Services and Supporting Regulations under 42 CFR 440.70(f) and (g) (CMS-10609)
0938-1318 Home Health Face-to-Face Encounter Clinical Templates (CMS-10564)
0938-1317 Reapplication Submission Requirement for Qualified Entities under ACA Section 10332 (CMS-10596)
0938-1316 (CMS-10600) Evaluation of the Medicare Patient Intravenous Immunoglobulin Demonstration
0938-1315 Appropriate Use Criteria (AUC) for Diagnostic Imaging Services: Clinical Decision Support Mechanism (CDSM) Application Process (CMS-10624)
0938-1314 Quality Payment Program/Merit-Based Incentive Payment System (MIPS) (CMS-10621)
0938-1313 Waiver Application for Providers and Suppliers Subject to an Enrollment Moratorium (CMS-10629)
0938-1312 Establishment of an Exchange by a State and Qualified Health Plans (CMS-10593)
0938-1311 Pre-Claim Review Demonstration For Home Health Services (CMS-10599)
0938-1310 Information Collection for Transparency in Coverage Reporting by Qualified Health Plan Issuers (CMS-10572)
0938-1309 QECP Annual Report Workbook Submission Requirement for Qualified Entities under ACA Section 10332 (CMS-10589)
0938-1308 Medicare Outpatient Observation Notice (MOON) (CMS-10611)
0938-1307 (CMS-10587) Medicare and Medicaid Programs: Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies
0938-1306 Temporary Reclassification for Grandfathered LTCH HwHs for Qualification for Temporary Exception from the Site Neutral Payment Rate for Certain Discharges
0938-1305 (CMS-10583) Medicare beneficiaries receiving beta amyloid positron emission tomography (PET) for dementia and neurodegenerative disease
0938-1304 Medicare and Medicaid Program; Program Integrity Enhancements to the Provider Enrollment Process (CMS-10576)
0938-1303 Small Business Health Options Program (SHOP) Effective Date and Termination Notice Requirements (CMS-10555)
0938-1302 Provider Network Coverage Data Collection (CMS-10594)
0938-1301 Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection (CMS-10595)
0938-1300 Healthy Indiana Program (HIP) 2.0 Beneficiary Focus Groups and Informational Interviews (CMS-10615)
0938-1299 Medicare and Medicaid Programs: Conditions of Participation for Home Health Agencies (HHA) (CMS-10539)
0938-1298 Federally Qualified Health Center Cost Report Form (CMS-224-14)
0938-1297 Generic Clearance for the Heath Care Payment Learning and Action Network (CMS-10575)
0938-1296 Medicare Advantage Model of Care Submission Requirements (CMS-10565)
0938-1295 Essential Community Provider Data Collection to Support QHP Certification for PY 2017 (CMS-10561)
0938-1293 Medicare Program: Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) (CMS-10524)
0938-1292 Coverage of Certain Preventive Services Under the Affordable Care Act (CMS-10459)
0938-1291 (CMS–10551) Nursing Home NationalProvider Survey
0938-1290 (CMS-10550) Hospital National Provider Survey
0938-1289 Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network (CROWNWeb) (CMS-10569)
0938-1288 Appropriate Use Criteria for Advanced Diagnostic Imaging Services (CMS-10570)
0938-1287 Rural Health Clinics (RHCs) Reporting of Healthcare Common Procedure Coding System (HCPCS) and Other Codes as Required for RHC Claims and Supporting Regulations (CMS-10568)
0938-1286 Quality Improvement Strategy Implementation Plan and Progress Report (CMS-10540)
0938-1285 Data Submission Requirements to Receive the Federally-facilitated Exchange User Fee Adjustment (CMS-10492)
0938-1284 Information Collection for Machine Readable Data for Provider Network and Prescription Formulary Content for FFM QHPs (CMS-10558)
0938-1283 Risk Corridors Data Validation for the 2014 Benefit Year (CMS-10582)
0938-1282 [Medicaid] Children's Health Insurance Program Managed Care and Supporting Regulations (CMS-10554)
0938-1281 State Review of Accreditation Status, Medicaid Managed Care Quality Rating System, and Quality Strategy (QS) and Supporting Regulations in 438.310, 438.330, 438.332, 438.334, and 438.340 (CMS-10553)
0938-1280 [Medicaid] Medical Necessity and Contract Amendments Under Mental Health Parity (CMS-10556)
0938-1279 Outcome and Assessment Information Set (OASIS-E2) (CMS-10545)
0938-1278 Implementation of Medicare Programs; - Medicare Promoting Interoperability Program (CMS-10552)
0938-1277 Program Integrity:Exchange, Premium Stabilization Programs, and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014; Final Rule II (CMS-10516)
0938-1276 Executive Summary Form for Research Identifiable Data (CMS-10522)
0938-1275 Generic Clearance for Questionnaire Testing and Methodological Research for the Medicare Current Beneficiary Survey (MCBS) (CMS-10549)
0938-1274 (CMS–10531) Transcatheter Mitral Valve Repair (TMVR) National Coverage Decision (NCD) (CMS-10531)
0938-1273 Emergency Department Patient Experience of Care (EDPEC) Survey Mode Experiments (CMS-10543)
0938-1272 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Mode Experiment (CMS-10542)
0938-1271 Good Cause Processes (CMS-10544)
0938-1270 Ambulatory Surgical Center Quality Reporting Program (CMS-10530)
0938-1269 Hospice Information for Medicare Part D Plans (CMS-10538)
0938-1268 [Medicaid] Medicaid Eligibility and Enrollment (EE) Implementation Advanced Planning Document (IAPD) Template (CMS-10536)
0938-1267 Risk Corridors Transitional Policy (CMS-10532)
0938-1266 Cost-Sharing Reduction Reconciliation (CMS-10526)
0938-1265 Quarterly Medicaid and CHIP Budget and Expenditure Reporting for the Medical Assistance Program, Administration and CHIP (MBES/CBES Forms CMS-21 and -21B, -37, and -64) -- (CMS-10529)
0938-1264 Programs of All-Inclusive Care for the Elderly (PACE) PACE Quality Data Monitoring and Reporting (10525)
0938-1263 Medicare Health Care Quality (MHCQ) Demonstration Evaluation: Focus Group and Interview Protocols (CMS-10497)
0938-1262 The Predictive Learning Analytics Tracking Outcome (PLATO™) - (CMS-10517)
0938-1261 Medicare and Medicaid Programs: Conditions of Participation for Community Mental Health Centers and Supporting Regulations in 42 CFR 485
0938-1260 Improving Quality of Care in Medicaid and CHIP through Increased Access to Preventive Services, State Survey (CMS-10521)
0938-1259 Health Care Sharing Ministries Information Collection
0938-1258 Disclosure of State Rating Requirements Notice (CMS-10454)
0938-1257 National Implementation of the Hospice Experience of Care Survey (CAHPs Hospice Survey) - CMS-10537
0938-1256 Evaluation of the Multi-payer Advanced Primary Care Practice (MAPCP) Demonstration: Provider Survey
0938-1255 (CMS-10519) Physician Quality Reporting System and the Electronic Prescribing Incentive Program Data Assessment, Accuracy and Improper Payments Identification Support
0938-1254 Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)
0938-1253 Evaluation of the Rural Community Hospital Demonstration
0938-1252 Prospective Evaluation of Evidence-Based Community Wellness and Prevention Programs (CMS-10509)
0938-1251 Healthcare Fraud Prevention Partnership (HFPP): Data Sharing and Information Exchange (CMS-10501)
0938-1250 Medicare Coverage of Items and Services in FDA Investigational Device Exemption Clinical Studies--Revision of Medicare Coverage (CMS-10511)
0938-1249 Marketplace Quality Standards (CMS-10520)
0938-1248 Employer Notification Request to HHS of its Objection to Providing Contraceptive Services (CMS-10535)
0938-1247 Generic Social Marketing & Consumer Testing Research (CMS-10437)
0938-1246 Application for Participation in the Intravenous Immune Globulin (IVIG) Demonstration (CMS-10518)
0938-1245 Conditions of Participation for Community Mental Health Centers and Supporting Regulations (CMS-10506)
0938-1244 State-based Marketplace Annual Reporting Tool (SMART) (CMS-10507)
0938-1243 Hospice Quality Reporting Program: Program Evaluation
0938-1242 Long Term Care Hospitals Quality Reporting Program: Program Evaluation
0938-1241 Inpatient Rehabilitation Facilities Quality Reporting Program: Program Evaluation
0938-1240 Outpatient and Ambulatory Surgery Experience of Care Survey (CMS-10500)
0938-1239 Nationwide Consumer Assessment of Healthcare Providers and Systems (DCAHPS) Survey for Adults in Medicaid (CMS-10493)
0938-1238 Community First Choice Option Evaluation
0938-1237 Registration, Attestation, Dispute Resolution and Correction, Assumptions Document and Data Retention Requirements for Open Payments (CMS-10495)
0938-1236 CMS Identity Management System (CMS-10452)
0938-1235 Medicare Prior Authorization of Power Mobility Devices (PMDs) Demonstration (CMS-10471)
0938-1234 End Stage Renal Disease (ESRD) System Access Request Form
0938-1233 Medicare Enrollment Application for Registration of Eligible Entities That Provide Health Insurance Coverage Complementary to Medicare Part B and Supporting Regulations
0938-1232 Medical Loss Ratio (MLR) Report for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10476)
0938-1231 Annual Report of Physician-Owned Hospital Ownership and/or Investment Interest
0938-1230 Application for Enrollment in Medicare Part B (Medical Insurance) (CMS-40B)
0938-1229 Survey on Core Competencies for the Direct Service Workforce (CMS-10512)
0938-1228 The Medicare Advantage and Prescription Drug Program: Part C Explanation of Benefits and Supporting Regulations (CMS-10453) - IRA
0938-1227 Requirements for the Medicare Incentive Reward Program and Provider Enrollment
0938-1226 Physician Quality Reporting System and the Electronic Prescribing Incentive Program
0938-1225 Medicaid Emergency Psychiatric Services Demonstration Evaluation
0938-1224 Evaluation of the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration: Focus Group Protocols
0938-1223 Evaluation of the Multi-Payer Advance Primary Care Practice (MAPCP) Demonstration: Conduct Beneficiary Experience with Care Surveys
0938-1222 Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for the Merit-Based Incentive Payment System (MIPS) (CMS-10450)
0938-1221 Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection (CMS-10488)
0938-1220 Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel
0938-1219 Medicaid Incentives for Prevention of Chronic Diseases Evaluation (CMS-10477)
0938-1218 [Medicaid] Basic Health Program Report for Health Insurance Exchange Premium (CMS-10510)
0938-1217 Payment Collections Operations Contingency Plan (CMS-10515)
0938-1216 State Health Insurance Exchange Security Incident Report
0938-1215 Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Exchanges (CMS-10463)
0938-1214 Issuer Reporting Requirements for Selecting a Cost-Sharing Reductions Reconciliation Methodology (CMS-10469)
0938-1213 Program Integrity and Additional State Information Collections
0938-1212 Evaluation of the Graduate Nurse Education Demonstration Program (CMS-10467)
0938-1211 Evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration
0938-1210 Report of a Hospital Dealth Associated with Restraint or Seclusion (CMS-10455)
0938-1209 Emergency Room Patient Experiences with Care Survey
0938-1208 Hospice Experience of Care Survey
0938-1207 Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment (CMS-10468)
0938-1206 Evaluation of Patient Satisfaction and Experience of Care for Medicare Beneficiaries with ESRD: Impact of the ESRD Prospective Payment System (PPS) and ESRD Quality Incentive Program (QIP)
0938-1205 Standards for Navigators and Non-Navigator Assistance Personnel; Consumer Assistance Tools and Programs of an Exchange and Certified Application Counselors
0938-1204 Agent/Broker Data Collection in Federally-facilitated Health Insurance Exchanges (CMS-10464)
0938-1203 Consumer Research Supporting Outreach for Health Insurance Marketplace
0938-1202 Transcatheter Valve Therapy Registry and KCCQ-10
0938-1201 Medicare Plan Finder Experiment
0938-1200 Evaluation and Development of Outcome Measures for Quality Assessment in Medicare Advantage and Special Needs Plans
0938-1199 MAC Satisfaction Indicator (MSI) Participant Registry
0938-1198 Medicare Enrollment Application for Clinics/ Group Practice and Certain Other Suppliers
0938-1197 Health Insurance Common Claims Form and Supporting Regulations at 42 CFR Part 424, Subpart C (CMS-1500 and CMS-1490S)
0938-1196 Home Health Change of Care Notice (HHCCN) (CMS-10280)
0938-1195 Medicare Advantage Quality Bonus Payment Demonstration
0938-1194 Data Collection to Support Eligibility Determinations and Enrollment for Employees in the Small Business Health Options Program (CMS-10438)
0938-1193 Data Collection to Support Eligibility Determinations and Enrollment for Small Businesses in the Small Business Health Options Program (CMS-10439)
0938-1192 Probable Fraud Measurement Pilot (CMS-10406)
0938-1191 Data Collection to Support Eligibility Determinations for Insurance Affordability Programs and Enrollment through Health Benefits Exchanges, Medicaid and CHIP Agencies (CMS-10440)
0938-1190 Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions (CMS-10466)
0938-1189 Minimum Essential Coverage (CMS-10465)
0938-1188 Medicaid and CHIP Program (MACPro) (CMS-10434)
0938-1187 Initial Plan Data Collection to Support QHP Certification and other Financial Management and Exchange Operations (CMS-10433)
0938-1186 Home and Community-Based Services (HCBS) Experience Survey
0938-1185 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)
0938-1184 Minimum Data Set for Medicaid Incentives for Prevention of Chronic Diseases Program Grantees
0938-1183 Surveys of Physicians and Home Health Agencies to Assess Access Issues for Specific Medicare Beneficiaries as Defined in Section 3131(d) of the ACA
0938-1182 Analysis of Transportation Barriers to Utilization of Medicare Services by American Indian and Alaska Native Medicare Beneficiaries
0938-1181 Durable Medical Equipment Face-to-Face Requirements
0938-1180 For-Profit PACE Study
0938-1179 Medicare Enrollment Application- Reassignment of Medicare Benefits (CMS-855R)
0938-1178 Medicare Enrollment Application for Physician and Non-Physician Practitioners
0938-1177 Medicare Beneficiary and Family-Centered Satisfaction Survey
0938-1176 Recognized Accrediting Entities Data Collection (45 CFR part 156.275)
0938-1175 PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program (CMS-10431)
0938-1174 Essential Health Benefits Benchmark Plans - CMS-10448
0938-1173 Transparency Reports and Reporting of Physician Ownership or Investment Interests (CMS-10419)
0938-1172 Blueprint for Approval of Affordable State-based and State Partnership Insurance Exchanges (CMS-10416)
0938-1171 Requirements for the Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program (CMS-10432)
0938-1170 Payments for Services Furnished by Certain Primary Care Providers and Supporting Regulations in 42 CFR 438.6, 438.804, 447.400, and 447.410 (CMS-10422)
0938-1169 Fee-for-Service Recovery Audit Prepayment Review Demonstration and Prior Authorization Demonstration (CMS-10421)
0938-1168 Cooperative Agreement to Support Establishment of the Affordable Care Act's Health Insurance Exchanges
0938-1167 Community Based Care Transitions Program (CCTP) Implementation and Monitoring
0938-1166 Health Plan Identifier, Other Entity Identifier, and Change to National Provider Identifier Requirements
0938-1165 Nursing Home Quality Improvement Questionnaire
0938-1164 Medical Loss Ratio Annual Reports, MLR Notices, and Recordkeeping Requirements (CMS-10418)
0938-1163 Long Term Care Hospital (LTCH) Quality Reporting Program (CMS-10409)
0938-1162 [Medicaid] Section 1115 Demonstration Projects Regulations at 42 CFR 431.408, 431.412, 431.420, 431.424, and 431.428 (CMS-10341)
0938-1161 Pre-Existing Condition Insurance Plan (PCIP) HIPAA Authorization Form
0938-1160 CMS National Balancing Indicators Project (NBIP) Direct Service Workforce (DSW) Data Collection Effort
0938-1159 Section 1115 Demonstration: Long Term Services and Supports and Other Service Models for Individuals with Disabilities and Chronic Conditions
0938-1158 Medicare and Medicaid Programs; Electronic Health Record Incentive Program
0938-1157 Student Health Insurance Coverage (CMS-10377)
0938-1156 Establishment of Qualified Health Plans and American Health Benefit Exchanges (CMS-10400)
0938-1155 Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment (CMS-10401)
0938-1154 Medication Therapy Management Program – Standardized Format (CMS-10396)
0938-1153 Hospice Voluntary Quality Data Reporting Program
0938-1152 Collection of Risk Adjustment Data from MA Organizations, Section 1876 Cost HMOS/CMPS, Section 1833 HCPPS, MMPS, and PACE Organizations (CMS-10340)
0938-1151 Medicaid Program; Medicaid State Plan Preprint for Use by States When Implementing Section 6401, Provider Screening and Other Enrollment Requirements Under Medicare, Medicaid and CHIP
0938-1150 Early Retiree Reinsurance Program: Survey of Plan Sponsors
0938-1149 Version 5010/ICD-10 Industry Readiness Assessment
0938-1148 [Medicaid] Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)
0938-1147 [Medicaid] Medicaid Program; Eligibility Changes under the Affordable Care Act of 2010 (CMS-10410)
0938-1146 Summary of Benefits and Coverage and Uniform Glossary (CMS-10407)
0938-1145 State Balancing Incentive Payments Program (BIPP)
0938-1144 Application To Be a Qualified Entity to Receive Medicare Data for Performance Measurement / Reapplication / Annual Report Worksheet (CMS-10394)
0938-1143 Consumer Research on Public Reporting of Hospital Quality Measures (CMS-10360)
0938-1142 Autism Spectrum Disorders (ASD): State of the States in Services and Supports for People with ASD
0938-1141 Rate Increase Disclosure and Review Reporting Requirements (CMS-10379)
0938-1140 Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD) and Supporting Regulations
0938-1139 Consumer Operated and Oriented Plan [CO-OP] Program (CMS-10392)
0938-1138 eRx Incentive Program Submission of Significant Hardship Exemption to Avoid the eRx Payment Adjustment
0938-1137 Letter Requesting Waiver of Medicare/Medicaid Enrollment Application Fee; Submission of Fingerprints; Submission of Medicaid Identifying Information; Medicaid Site Visit and Rescreening (CMS-10357)
0938-1136 Provider-Preventable Conditions under 42 CFR 438.6 and 447.26 and Title 2702 Non-Payment Preprint (Attachment 4.19)
0938-1135 Medicare Registration Application (CMS-855O)
0938-1134 [Medicaid] Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204 (CMS-10391)
0938-1133 Disclosure Requirement for the In-Office Ancillary Services Exception (CMS-10332)
0938-1132 Medical Loss Ratio - Quarterly Reporting for Mini-med Plans and Expatriate Plans
0938-1131 Medicaid Emergency Psychiatric Demonstration
0938-1129 Quality Bonus Payment Appeals (CMS-10346)
0938-1128 Medicaid State Plan Preprint for Use by States When Implementing Section 6505, the Prohibition on Payments to Institutions or Entities Located Outside of the United States
0938-1127 Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services (CMS-10344)
0938-1126 State Plan Preprint for Medicaid Recovery Audit Contractor (RAC) Program (CMS-10343)
0938-1125 Expedited Checklist: Medicaid Eligibility & Enrollment Systems - Advance Planning Document (E&E-APD ) (CMS-10385)
0938-1124 Medicare Community-based Care Transitions Program
0938-1123 MMIS APD Template for Use by States When Implementing the Mandatory National Correct Coding Initiative in Medicaid, implementation of Section 6507 of ACA (CMS-10358)
0938-1122 Current State Practices Related to Payments to Providers for Health Care-Acquired Conditions
0938-1121 Reporting Requirements for Grants to States for Rate Review Cycle IV and Effective Rate Review Program (CMS-10380)
0938-1120 Evaluation of Practice Models for Dual Eligibles and Medicare Beneficiaries with Serious Chronic Conditions
0938-1119 Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges (CMS-10371)
0938-1118 Preliminary Establishment for Territories Cooperative Agreements for the Affordable Care Act Exchanges
0938-1117 The Medicare Acute Care Episode Demonstration
0938-1116 Patient Safety Survey Under the 9th SOW: Nursing Home In Need (NHIN)
0938-1115 Medicare Part C and Part D Data Validation (42 CFR 422.516g and 423.514g) (CMS-10305)
0938-1114 Medical Loss Ratio (IFR) Information Collection Requirements and Supporting Regulations (CMS-10361)
0938-1113 Medicare Prescription Drug Plan (PDP) and Medicare Advantage Prescription Drug Plan (MA-PD) Disenrollment Reasons Survey
0938-1112 Survey to Inform the Children's Health Insurance Program (CHIP) National Outreach & Education Campaign
0938-1111 Electronic Submission of Medicare Graduate Medical Education (GME) Affiliation Agreements (CMS-10326)
0938-1110 Cooperative Agreements to Support Innovative Exchange Information Technology Systems
0938-1109 Information Collection Requirements for the Hospital Outpatient Quality Data Program (HOPQDRP) (CMS-10250)
0938-1108 Medicaid Savings Program Protection from Medicaid Estate Recovery -- State Plan Preprint Under Title 19 (CMS-10314)
0938-1107 Parts C and D Complaints Resolution Performance Measures
0938-1106 Medicare Self-Referral Disclosure Protocol(CMS-10328)
0938-1105 Process for Obtaining Waivers of the Annual Limits Requirements of PHS Act Section 2711
0938-1104 Program Evaluation of the Ninth Scope of Work Quality Improvement Organization Program (CMS-10294)
0938-1103 Medicare Gainsharing Demonstration Evaluation: Physician Focus Groups
0938-1102 Medicare Quality of Care Complaint Form (CMS-10287)
0938-1101 Limited Competition for State Planning and Establishment Grants for the Affordable Care Act's Exchanges
0938-1100 Pre-Existing Condition Insurance Plan and Supporting Regulations
0938-1099 Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-grandfathered Group Health Plans and Issuers and Individual Market Issuers (CMS-10338)
0938-1098 Tribal Consultation State Plan Amendment Template (CMS-10293)
0938-1097 Grants to States for Consumer Assistance Program
0938-1096 Data Collection for Developing Outpatient Therapy Payment Alternatives (DOTPA)
0938-1095 Application for Coverage in the Pre-Existing Condition Insurance Plan
0938-1094 Notice of Rescission of Coverage and Disclosure Requirements for Patient Protection under the Affordable Care Act (CMS-10330)
0938-1093 Disclosure and Recordkeeping Requirements for Grandfathered Health Plans under the Affordable Care Act (CMS-10325)
0938-1092 Grants to States for Health Insurance Premium Review
0938-1091 Comprehensive Outpatient Rehabilitation Facilites (CORFs) Conditions of Participation (CoP) and Supporting Regulations
0938-1090 Electronic Health Records (EHR) Testing
0938-1089 Affordable Care Act Enrollment Opportunity Notice Relating to Extension of Dependent Coverage
0938-1088 State Medicaid HIT Plan and Template for Implementation of Section 4201 of ARRA (CMS-10292)
0938-1087 Early Retiree Reinsurance Program
0938-1086 Health Care Reform Insurance Web Portal Requirements 45 CFR part 159 (CMS-10320)
0938-1085 Temporary High Risk Pool Program (CMS-10319)
0938-1084 Additional State Plan Option for Providing Premium Assistance State Plan Templates under Title XIX and XXI (CMS-10300)
0938-1083 Medicare program/Home Health Prospective Payment System Rate Update for CY2010:Physician Narrative Requirement, CY2011 Proposed Physician Face-to-Face Encounter
0938-1082 Option to Cover Certain Children and Pregnant Women Lawfully Residing in the U.S. State Plan Amendment Template (CMS-10299)
0938-1081 Consumer Research on Public Reporting of Hospital Outpatient Measures (CMS-10310)
0938-1080 Medical Necessity Disclosure Under MHPAEA and Claims Denial Disclosure Under MHPAEA (CMS-10307)
0938-1079 Grandfathering Provisions of the Medicare DMEPOS Competitive Bidding Program in the Physician Fee Schedule and Other Revisions to Part B for CY 2010
0938-1078 Collection Requirements for Compendia for Determination of Medically-Accepted Indications for Off-label Uses of Drugs and Biologicals in an Anti-Cancer Chemotherapeutic Regimen (CMS-10302)
0938-1077 Notice of Research Exception under the Genetic Information Nondiscrimination Act (CMS-10286)
0938-1076 State Plan Pre-print to Implement Required Dental Benefits Pursuant of CHIPRA 2009 (CMS-10288)
0938-1075 Optional Dental-only Supplemental Coverage SPA Template (CMS-10289)
0938-1074 Mandatory Insurer Reporting Requirements of Section 111 of the Medicare, Medicaid and SCHIP Act of 2007 (CMS-10265)
0938-1073 Recovery Act - Reporting Requirements for States Under TMA Provisions (CMS-10295)
0938-1072 Evaluation of the Medicare Care Management Performance Demonstration and the Electronic Health Records Demonstration
0938-1071 Ambulatory Surgical Centers Conditions of Coverage (CMS-10279)
0938-1070 State Plan Amendment Template for Transitional Medical Assistance for Low-Income Families (CMS-10283)
0938-1069 Conditions of Participation: Requirements for Approval and Reapproval of Transplant Centers to Perform Organ Transplants and Supporting Regulations in 42 CFR 482.74, 482.94, 482.100, 482.102, 488.61
0938-1068 Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009, State Option Pre-print to Include Pregnant Women in Title XXI. (CMS-10284)
0938-1067 Hospice Conditions of Participation and Physician Narrative on the Certification or Recertification of Terminal Illness (42 CFR 418.22(b)(3))
0938-1066 CAHPS Home Health Care Survey (CMS-10275)
0938-1065 [Medicaid] State Collection and Reporting of Dental Provider and Benefit Package Information on the Insure Kids Now! Website and Hotline (CMS-10291)
0938-1064 Evaluation of the Home Health Pay for Performance Demonstration: Survey instrument
0938-1063 National Medicare Training Program Needs Assessment Survey
0938-1062 Recovery Act of 2009 - Request for Review If You Have Been Denied Premium Assistance
0938-1061 Supplemental Appropriations Act of 1008 Mandated Report to Congress (CMS-10281)
0938-1060 Hospital Leadership Quality Assessment Tool (HLQAT)
0938-1059 Physician Quality Reporting System (PQRS) (CMS-10276)
0938-1058 Medicare Registration Summary and Medication History Personal Health Record Evaluation
0938-1057 Evaluation of the Medicare Care Management Performance Demonstration
0938-1056 Medicare Enrollment Application: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers (Form 855S)
0938-1055 HIFA Evaluation Enrollee Survey (CMS-10262)
0938-1054 Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a) (CMS-10261)
0938-1053 [Medicaid] Administrative Requirements for Section 6071 of the Deficit Reduction Act of 2005 (CMS-10249)
0938-1052 Consolidated Renal Operations in a Web Enabled Network (CROWNWeb) Third-party Submission Authorization Form
0938-1051 Medicare Advantage Disclosure Requirements referenced in 42 CFR 422.111(d)(2)
0938-1050 QualityNet Identity Management System (QIMS) Account Form
0938-1049 Emergency Ambulance Transports and Beneficiary Signature Requirements in 42 CFR 424.36(b) (CMS-10242)
0938-1048 Evaluation of Care and Disease Management Under Medicare Advantage
0938-1047 State Plan Pre-print for Integrated Medicare and Medicaid Programs (CMS-10251)
0938-1046 Certificate of Data Destruction for Data Acquired from the Centers for Medicare and Medicaid Services
0938-1045 State Plan Template to Implement Section 6062 of the DRA (Opportunity for Families of Disabled Children to Purchase Medicaid Coverage for Such Children) CMS-10232
0938-1044 Submission of Information for the Hospital Outpatient Quality Data Program
0938-1043 Conditions of Participation for Critical Access Hospitals and Supporting Regulations in 42 CFR 485.23, 485.618, 485.618, 485.631, 485.635, 485.641, 485.643, 485.645
0938-1042 Healthcare Common Procedure Coding System (HCPCS) - Level II Code Modification Request Process (CMS-10224)
0938-1041 [Medicaid] Survey of Retail Prices (CMS-10241)
0938-1040 Testing of Revised OASIS Instrument for Home Health Quality Measures & Data Analysis
0938-1039 Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration
0938-1038 Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration
0938-1037 Testing Experience and Functional Tools: Functional Assessment Standardized Items (FASI) Based on the CARE Tool (CMS-10243)
0938-1036 Survey of Contract Labor in Selected Health Industries
0938-1035 Provider Enrollment Chain and Ownership System (PECOS) Web Security Consent Form (CMS-10220)
0938-1034 Disclosures to Patients by Certain Hospitals and Critical Access Hospitals and Supporting Regulations in 42 CFR 489.20
0938-1033 Medicaid State Program Integrity (SPIA) CMS-10244
0938-1032 Regional PPO Risk-Sharing Reconciliation Cost Report
0938-1031 Physician Survey for the 2006 Medicare Oncology Demonstration Program
0938-1030 Medicare Competitive Acquisition Program (CAP) for Part B Drugs Evaluation: CAP Physician Survey
0938-1029 Worksheet for Recording Results of Medicare Site Visits of Independent Diagnostic Testing Facilities (IDTFs) (CMS-10221)
0938-1028 HEDIS Information Collection Request
0938-1027 PACE State Plan Amendment Pre-print (CMS-10227)
0938-1026 [Medicaid] Identifying Medicaid Payment for Physician Administered Drugs (CMS-10215)
0938-1025 Evaluation of the Medical Adult Day-Care Services Demonstration - Phase I
0938-1024 State Plan Pre-print implementing Section 6087 of the DRA: Optional Self Direction PAS Program (Cash and Counseling) CMS-10234
0938-1023 Medicare Advantage Chronic Care Improvement Program (CCIP) Attestations (CMS-10209)
0938-1022 Hospital Reporting Initiative--Hospital Quality Measures (CMS-10210)
0938-1021 Assessing Degrees of Health Care Involvement Survey
0938-1020 Requirements for Requests by Hospitals for an Alternative Cost-to-Charge Ratio and Supp. Regs. in 42CFR412.84(i)(2),412.525(a)(4)(ii), 412.525(a)(4)(iv)(A), 412.529(c)(3)(ii) and 412.529(c)(3)(iv)(A)
0938-1019 Medicare and Medicare Advantage Programs; Notification Procedures for Hospital Discharges Detaile (CMS-10066)
0938-1018 Evaluation of the Medical Adult Day-Care Services Demonstration - Phase I
0938-1017 Evaluation of the Medical Adult Day-Care Services Demonstration - Phase I
0938-1016 Supporting Statement For Paperwork Reduction Act Submissions - Request for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program and Suppo
0938-1015 Evaluation of Medicare National Competitive Bidding Program for DME
0938-1014 Data Collection for Administering the Medicare Health Improvement Survey
0938-1013 Creditable Coverage Disclosure to CMS OnLine Form and Instructions (CMS-10198)
0938-1012 Payment Error Rate Measurement - State Medicaid and SCHIP Eligibility
0938-1011 Data Collection for Medicare Facilities Performing Carotid Artery Stenting with Embolic Protection in Patients at High Risk for Carotid Endarterectomy
0938-1010 Mail Survey of Medicare Advantage Special Needs Plans / Focus Groups with Enrollees of Medicare Advantage SNPs
0938-1009 Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)
0938-1008 Medicare Clinical Laboratory Services Competitive Bidding Demonstration Project : Bidding Form
0938-1007 Alternative Benefits State Plan Amendment Health Opportunity Accounts Demonstration Program (CMS-10216)
0938-1006 Evaluation of Home Health Independence Demonstration: Home Health Agency Survey
0938-1005 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Accreditation Proposals from Independent Accrediting Bodies
0938-1004 Medicare Part C Audit Guide, Version 4 contained in 42 CFR 423.502
0938-1003 National Evaluation of the Demonstration to Improve the Direct Service Community Workforce
0938-1002 Evaluation of the Medicare Audit Recovery Audit Contractor Demonistration and RAC Provider Satisfaction Survey
0938-1001 Voluntary Sample AMP Collection
0938-1000 Medicare Parts C and D Universal Audit Guide
0938-0999 Insurance Common Claims Form and Supporting Regulations at 42 CFR Part 424 Subpart C
0938-0998 Evaluation of the Demonstration of Coverage of Chiropractic Services Under Medicare
0938-0997 Medicare Uniform Institutional Provider Bill and Supporting Regulations in 42 CFR 424.5 (CMS-1450)
0938-0996 Enrolling Low-Income Beneficiaries into the Medicare Prescription Drug Program Survey of State Agency Experiences
0938-0995 Strategic and Implementing Plan Regarding Specialty Hospitals - Section 5006 of the DRA
0938-0994 Payment Error Rate Measurement in Medicaid & Children's Health Insurance Program (CHIP) (CMS-10178)
0938-0993 State Plan preprints to implement Sections of the Deficit Reduction Act of 2006 (CMS-10190)
0938-0992 Medicare Part D Reporting Requirements under 42 CFR section 423.505
0938-0990 Model Creditable Coverage Disclosure Notices
0938-0989 Individuals Authorized Access to the CMS Computer Services
0938-0988 State Children's Health Insurance Program (SCHIP) Report on Payables and Receivables (CMS-10180)
0938-0987 Competitive Acquisition Program (CAP) for Medicare Part B Drugs: CAP Physician Election Agreement
0938-0986 Rehabilitation Unit Criteria Work Sheet and Rehabilitation Hospital Criteria Work Sheet and Supporting Regulations at 42 CFR 412.20-412.30 (CMS-437A&B)
0938-0985 Medicare Health Support Program Medical Records Abstraction
0938-0984 Certification Statement for Electronic File Interchange Organizations that Submit NPI Data to the National Plan and Provider Enumeration System (CMS-10175)
0938-0983 Medicare EDI Enrollment Form and EDI Registration (CMS-10164 A/B)
0938-0982 Collection of Prescription Drug Data from MA-PD, PDP and Fallout Plans/Sponsors for Medicare Part D Payments (CMS-10174) - IRA
0938-0981 National Implementation of Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) CMS-10102
0938-0980 Medicare Care Improvement Survey
0938-0979 New Freedom Initiative - Web-based Reporting System for Grantees (CMS-10161)
0938-0978 Part D Coordination of Benefits Data (CMS-10171)
0938-0977 Retiree Drug Subsidy Payment Request Instructions (CMS-10170)
0938-0976 Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146)
0938-0975 Standardized Pharmacy Notice: Your Prescription Cannot be Filled (f/k/a Medicare Prescription Drug Coverage and Your Rights) (CMS-10147)
0938-0974 Payment Error Rate Measurement in Medicaid and the State Children Health Insurance Program (CMS-10166)
0938-0973 Physician Assessment of Hospital Quality Reports
0938-0972 Consumer Assessment of Health Behaviors Survey
0938-0971 Medicare Program: Conditions of Payment of Power Mobility Devices, Including Power Wheelchairs and Power-Operated Vehicles (CMS-3017-IFC)
0938-0969 Medicare Program: Complex Medical Review
0938-0968 Data collection for Medicare Beneficiaries Receiving FDG Positron Emission Tomography (PET) for Brain, Cervical, Ovarian, Pancreatic, Small Cell Lung, and All Other Cancers
0938-0967 Data Collection for Medicare Beneficiaries Receiving Implantable Cardioverter-defibrillators for Primary Prevention of Sudden Cardiac Death
0938-0965 Electronic Health Records (EHR) Demonstration System (EHRDS) - practice application and profile update system
0938-0964 Medicare Prescription Drug Benefit Program - IRASA (CMS-10141)
0938-0963 1-800-MEDICARE Customer Experience Questionnaire
0938-0960 The HIPAA Eligibility Transaction System (HETS) (CMS-10157)
0938-0959 HCAHPS Cost Information
0938-0958 State Data for the Medicare Modernization Act (MMA) (CMS-10143)
0938-0957 Retiree Drug Subsidy (RDS) Application and Instructions (CMS-10156)
0938-0956 Beneficiary Survey on the Medicare Home Health Independence Demonstration
0938-0955 Medicare Part B Drug and Biological Competitive Acquisition Program Applications
0938-0954 Medicare Part B Drug and Biological Competitive Acquisition Program and Supporting Regulations in 42 CFR Sections 414.906, 414.908, 414.910, 414.914, 414.916, and 414.917
0938-0953 Notice of Provider Non-Coverage (CMS-10123) and Detailed Explanation of Non-Coverage (CMS-10124)
0938-0952 Federal Funding of Emergency Health Services (Section 1011); Provider Payment Determination and On-Call Cost Forms
0938-0951 Collection of Drug Pricing and Network Pharmacy Data from Medicare Prescription Drug Plans (PDP and MA-PD) and Supporting Regulations in 42 CFR 423.48
0938-0950 Appointment of Representative and Supporting Regulations in 42 CFR 405.910 (CMS-1696)
0938-0949 Health Insurance Reform: Security Standards; Final Rule
0938-0948 HIPPA Administrative Simplification Non-Privacy Enforcement
0938-0944 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10142)
0938-0943 Evaluation of Medicare Disease Management Demonstrations
0938-0942 Physician Group Practice (PGP) Standardized Ambulatory Care Quality Measure Collection Initiative
0938-0941 Medicare Demonstration Ambulatory Care Quality Measure Performance Assessment Tool ("PAT")
0938-0940 OASIS Study: OASIS Cost and Benefit Survey of Home Health Agencies and Supporting Regulations 42 CFR Parts 484 and 488
0938-0939 Phone Surveys of Product/Service for Medicare Payment Validation and Supporting Regulations in 42 CFR, 405.502
0938-0938 Public Reporting on Quality Outcomes National Survey of Hospital Executives ("PRO QUO")
0938-0937 Beneficiary Survey on the Medicare Drug Replacement Demonstration
0938-0936 Solicitation for Applications for Medicare Prescription Drug Plan 2027 Contracts (CMS-10137)
0938-0935 Qualification-Medicare Advantage Application for Coordinated Care Private Fee-For-Service, Regional Preferred Preferred Provider Organization, Service Area Expansion for Coordinated Care.......
0938-0934 Religious Nonmedical Health Care Institutions (RNHCI) and Supporting Regulations in 42 CFR Section 403.766
0938-0933 1932 State Plan Amendment Template, State Plan Requirements, and Supporting Regulations in 42 CFR 438.50 (CMS-10120)
0938-0932 Evaluation of PACE as a Permanent Program and a For Profit Demonstration
0938-0931 National Provider Identifier (NPI) Application and Update Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR 162.406 (CMS-10114)
0938-0930 Medicare Authorization to Disclose Personal Health Information (CMS-10106)
0938-0929 FEDERAL REIMBURSEMENT OF EMERGENCY HEALTH SERVICES FURNISHED TO UNDOCUMENTED ALIENS (SECTION 1011) PROVIDER ENROLLMENT APPLICATION
0938-0926 National Implementation of In-Center Hemodialysis CAHPS Survey (CMS-10105)
0938-0925 Grants to State Phamaccurical Assistance Program (SPAP)
0938-0924 Application for Participation in Medicare Replacement Drug Demonstration
0938-0922 Instrument/tool for refinement of a prospective payment system for patients in inpatient psychiatric hospitals, and units: a pilot test
0938-0921 [IRA] Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biological and Supporting Regulations (CMS-10110)
0938-0920 Medicaid Managed Care and Supporting Regulations in 42 CFR 438.6, 438.8, 438.10, 438.12, 138.50, 438.56, 438.102, 438.114, 438.202, 438.206, 438.207, 438.240, 438.242, 438.402, 438.404, 438.406...
0938-0919 1-800-MEDICARE Beneficiary Satisfaction Survey (CMS-100098)
0938-0918 National Voluntary Hospital Reporting Initiative--Hospital Quality Measures
0938-0917 Survey of Medicare Preferred Provider Organization Demonstration
0938-0916 Paid Feeding Assistants in Long Term Care Facilities and Supporting Regulations Contained in 42 CFR 483.160
0938-0915 Medicare Contractor Provider Satisfaction Survey (MCPSS) and Supporting Regulations in 42 CFR 421.120, 421.122 and 421.201
0938-0913 Medicare Drug Payment Exceptions Process
0938-0912 Medicare Health Survey (MHS)
0938-0911 Review of National Coverage Determinations and Local Coverage Determinations and Supporting Regulations in 42 CFR, Sections 426.400 and 426.500
0938-0910 Detailed Explanation of Non-Coverage (42 CFR 422.626(e)(1)), and Notice of Medicare Non-Coverage (42 CFR 422.624(b)(1))
0938-0909 Medicare Endorsed Prescription Drug Discount Card and Transitional Low-Income Assistance Program Response Form
0938-0907 Hospital Wage Index Occupational Mix Survey(CMS-10079)
0938-0906 Evaluation of the Medicaid Health Reform Demonstrations
0938-0905 UPIN (Unique Physician Identification Number)/Participating Physicians Directory
0938-0903 CMS/AoA Aging and Disability Resource Center Grant Program (Real Choice Systems Change Grants for Community Living and the Older Americans Act, Public Law 106-501 (Catalog of Federal Domestic...
0938-0902 Evaluation of the Illinois and Wisconsin State Pharmacy Assistance Waivers
0938-0901 Real Choice Systems Change Grants for Community Living: Included the following ten separate grants: Feasibility Studies and Development Grants 1. Respite for Adults; 2. Respite for......
0938-0900 MSInteractive Survey Tool for cms.hhs.gov website
0938-0899 Data Collection for Administering The PACE Health Survey To Beneficiaries Enrolled In The Dual Eligible Demonstrations, Minnesota Senior Health Options and Minnesota Disability Health..
0938-0898 CMSO Survey of States: Performance Measurement Reporting Capability
0938-0897 Notification of MACs and CMS of Co-Located Medicare Providers
0938-0896 Demonstration to Improve the Direct Service Workforce
0938-0895 Medicare Part A Provider and Durable Medical Equipment Supplier Satisfaction Study
0938-0894 Medicare Ombudsman Customer Service Feedback Survey (CMS-10068)
0938-0893 Data Collection for Administering the Survey for the Evaluation of the Demonstration to Maintain Independence and Employment (DMIE)
0938-0892 Publications Use Study
0938-0891 Pilot Test of Hospital CAHPS Survey
0938-0890 Design and Implementation of a Targeted Beneficiary Survey on Access to Physicians Services Among Medicare Beneficiaries
0938-0889 Pharmacy Plus Template Application
0938-0888 Survey of Rural Medicare Provider Education Needs
0938-0887 Matching Grants to States for the Operation of High Risk Pools
0938-0885 Medicare-Endorsed Prescription Drug Card Assistance Initiative
0938-0883 Standards for Privacy of Individually Identifiable Health Information and Supporting Regulations at 45 CFR Parts 160 and 164
0938-0882 Medicare Endorsed Prescription Drug Card Assistance Initiative
0938-0880 Medicare/Medicaid Demonstration/Model Application (CMS-10069)
0938-0879 Making Good Choices Survey
0938-0878 Collection of Diagnostic Data in the Abbreviated RAPS Format from Medicare Advantage Organizations for Risk Adjusted Payments (CMS-10062)
0938-0877 Evaluation of Programs of Coordinated Care and Disease Management
0938-0876 Evaluation of the MassHealth Insurance Partnership
0938-0875 Durable Medicare Equipment Regional Carrier, Certification of Medical Necessity and Supporting Documentation Requirements
0938-0874 HIPAA Standard Unique Employer Identifier and Supporting Regulations in 45 CFR Part 160 and 162
0938-0873 Quality Assessment and Performance Improvement (QAPI) Project Completion Report, 42 CFR 422.152
0938-0872 Minimum Data Set (MDS) For Swing Bed Hospitals and Supporting Regulations in 42 CFR 483.20 and 413.337
0938-0871 Medicare Lifestyle Modification Program Demonstration
0938-0869 Survey of Newly Eligible Medicare Beneficiaries
0938-0868 Administration Demonstration Initiatives Proposal Solicitation Package
0938-0867 Survey of Medicare Private Fee-for-service (PFFS) Enrollees and Nonenrollees
0938-0866 ICRs Contained in 45 CFR Part 162; HIPAA Standards for Electronic Transactions
0938-0864 Medicare Current Beneficiary Survey -- Supplement on Patient Activation
0938-0863 Evaluation of the BadgerCare Medicaid Demonstration
0938-0862 Medicare Lifestyle Modification Program Demonstration
0938-0860 Recognition of Payment for New Technology Services for Ambulatory Payment Classifications under the Outpatient Propsective Payment System (CMS-10054)
0938-0859 NMEP Regional Survey of Medicare Beneficiaries
0938-0857 Recognition of pass-through payment for additional (new) categories of devices under the Outpatient Prospective Payment System and Supporting Regulations in 42 CFR, Part 419
0938-0855 Upper Payment Limits Reporting Requirements and Supporting Regulations Contained in 42 CFR 447.272 and 447.321
0938-0852 Durable Medicare Equipment and Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Survey: Texas
0938-0851 Assessing the CMS Fall Campaigns
0938-0850 State Health Insurance Assistance Program (SHIP) Client Report
0938-0848 Health Insurance Flexibility and Accountability Section 1115 Model Waiver
0938-0847 Long-Term Care Awareness Campaign Demonstration Project
0938-0846 Physicians' Referrals to Health Care Entitles With Which They Have Financial Relationships and Supporting Regulations in 42 CFR, Sections 411.352, 411.354,411.355,411.357 and 411.361
0938-0845 "Medicare Endorsed Rx Discount Card Initiative
0938-0844 Medicare Health Survey (MHS) and Data Collection for Administering the PACE Health Survey to Beneficiaries Enrolled in PACE and the Dual Eligible Demonstrations
0938-0843 Healthy Aging Smoking Cessation Demonstration
0938-0842 Request to Use Inpatient Rehabilitation Assessment Instrument and Data Set for PPS for Inpatient Rehabilitation Facilities: Implementation Phase and Supporting Regulations in 42 CFR, ....
0938-0841 [Medicaid] State Children's Health Insurance Program and Supporting Regulations (CMS-R-308)
0938-0840 Collection of Data on Quality Indicators for Congestive Heart Failure Submitted by Medicare+Choice Organizations Requesting Extra Payments in CY2002 and CY2003 and Supporting Regulations...
0938-0839 National Medicare Practitioner and Provider Survey
0938-0838 Data Collection to Support Policy Analysis of Choices Offered to Medicare + Choice Enrollees and Choices Made by Enrollees
0938-0837 Medicare Program Integrity Customer Service Project
0938-0836 Real Choice Systems Change Grants; Nursing Facility Transition/Access Housing Grants; Community Personal Assistance Service and Supports Grants, National Technical Assistance......
0938-0834 Durable Medical Equipment and Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Survey
0938-0833 Restraint and Seclusion Standards for Psychiatric Residential Treatment Facilities (CMS-R-306)
0938-0832 Health Insurance Benefit Agreement and Supporting Regulations at 42 CFR Part 489 and 491 (CMS-1561)
0938-0829 of Denial of Medical Coverage (NDMC), and the Notice of Denial of Payment (NDP) - 42 CFR 422.568
0938-0828 Medicare Beneficiary Customer Service Survey
0938-0827 HIPAA Nondiscrimination Provisions (Regulation HCFA-2022-IFC)
0938-0826 Survey of Medicaid Home and Community-Based Services Waiver and Personal Care Option Recipients for the Multi-Site Study of Medicaid HOme and Community-Based Services
0938-0825 Stages of Change Survey for Informed Choice in the Medicare Population
0938-0824 Restraints/Seclusion Death Reporting for Hospitals and Supporting Regulations at 42 CFR 482.13
0938-0823 Suggestion Program on Methods to Improve Medicare Efficiency and Supporting Regulations in 42 CFR 420.410
0938-0820 Follow-Up of Medicare+Choice Disenrollees Receiving Fee-for-Service Inpatient Hospital Care
0938-0819 HIPAAA Nondiscrimination Provisions (Regulation HCFA-2078-P)
0938-0818 Expanded Coverage for Diabetes Outpatient Self-Management Training Services and Supporting Regulations Contained in 42 CFR 410.141, 410.142, 410.143, 410.144, 410.145, 410.146....
0938-0817 Survey of Medicare Beneficiaries Who Involuntarily Disenroll From Their Health Plan
0938-0813 Evaluation of the OMB and SLMB Programs -- Beneficiary Survey
0938-0812 Employee Building Pass Application and File
0938-0811 Ticket to Work and Work Incentives: Medicaid Infrastructure Grants
0938-0810 Hospital Condition of Participation; Identification of Potential Organ, Tissue, & Eye Donors & Transplant Hospitals' Provision of Transplant-Related Data & Supporting Regulation at 42 CFR 482.45
0938-0808 Study to Support Development and Refinement of a Classification System and Prospective Payment System for Patients in Inpatient Rehabilitation Hospitals and Exempt Rehabilitation Units
0938-0807 Oxygen Consumer Survey: Medical Equipment and Supplies Consumer Survey
0938-0806 Informatics, Telemedicine, and Education Demonstration Project
0938-0805 Collection of Data on Physician Encounters from Medicare + Choice Organizations
0938-0804 Medicare DMEPOS Competitive Bidding Demonstration: Follow-up to Original Survey
0938-0802 Transitional Pass through payments related to Drugs, Biologicals, and Radiopharmaceuticals to determine eligibility under the Outpatient Prospective Payment System(CMS-10008)
0938-0801 Evaluation of QMB and SLMB Outreach Activities
0938-0800 Application Requirements: Solicitation for Proposals for the Medicare Coordinated Care Demonstration
0938-0799 TWWIIA Demonstration to Maintain Independence and Employment Grants
0938-0798 Prospective Payments for Hospital Outpatient Services and Supporting Regulations in 42 CFR 413.65 (CMS-R-240)
0938-0797 Individual Market-Guarantee Issue Election Packet, Supporting Regulations 45 CFR 148, and forms/instruction
0938-0796 Medicare Consumer Assessment of Health Plan Survey-Fee For Service (CAHPS-FFS)
0938-0795 Conflict of Interest and Ownership and Control Information
0938-0794 Health Care Services for Deaf and Hard of Hearing Adults - Case Story Forms
0938-0792 Rural Health Clinics: Amendments to Participation Requirements & Payment Provisions; & Establishments of a Quality Assessment & Performance Improvement Program & Supporting Regulations.....
0938-0791 A Project to Develop an Outcome-Based Continuous Quality Improvement System for PACE
0938-0790 Medicare and Medicaid; Programs For All-Inclusive Care For The Elderly (PACE) Contained in 42 CFR Part 460 (CMS-R-244)
0938-0789 Survey and Evaluation of New Members of Medicare+Choice Plans
0938-0787 Request for Employment Information (CMS-R-297/CMS-L564)
0938-0786 [Medicaid] External Quality Review (EQR) of Medicaid and Children’s Health Insurance Program (CHIP) Managed Care, EQR Protocols, and Supporting Regulations (CMS-R-305)
0938-0785 HCFA Day One Information Collection
0938-0784 Flexibility in Payment Methods for Hospitals, Nursing Facilities, Supporting Regualtions in 42 CFR 447.254
0938-0783 Market Survey of Fraud, Waste, and Abuse Detection Software
0938-0782 Multi-State Evaluation of Dual Eligibles Demonstrations: Wisconsin Partnership Program
0938-0781 Information Collection Requirements and Supporting Regulations in 42 CFR, Section 484.10(a)
0938-0780 Medicare Telephone Customer Satisfaction Survey
0938-0779 Medicare CAHPS Disenrollment Surveys and Supporting Regs. in 42 CFR 417.126, 417.470, 422.64, and 422.210
0938-0778 Medicare+Choice Organization Appeals and Grievance Data Collection and Reporting Requirements -- Section 422.111; 422.64 Data Disclosure Requirements -- 42 CFR Section 422.111, 42 CFR...
0938-0777 Medicare Lifestyle Modification Program Demonstration and Addendum
0938-0776 Medicare Program: Process for Making National Coverage Determinations (CMS-R-290)
0938-0775 National Hospital Malpractice Insurance Survey (NHMIS)
0938-0774 Medicare Competitive Pricing Demonstration Bid Solicitation Package for Kansas City
0938-0773 Collection of Assessment Information on the Partners' Website of www.Medicare.gov/nmep
0938-0772 Peer Review Evaluation of Access to and Quality of Home Oxygen Equipment
0938-0771 Survey of Medicare Beneficiaries for the National Medicare and You Handbook: 2000 Evaluation
0938-0770 Site Visit Assessment Tool (previously known as Community Mental Health Center Site Visit Assessment Tool) and Supporting Regulations in 432 CFR 410.2
0938-0769 Request for Retirement Benefit Information (CMS-R-285)
0938-0768 Medicare Agreement Application, Health Care Prepayment Plan, and Supporting Regulations in 42 CFR Section 417.800-.840
0938-0767 Medigap Compare
0938-0766 Feedback Postcard
0938-0765 Evaluation of Medicare+Choice Medical Savings Account Demonstration; Insurer Survey Component
0938-0764 Publication Information Sheet Reorder Form Feedback Questionnaire
0938-0763 The Plan Benefit Package (PBP) and Formulary Submission for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDPs)
0938-0761 Medicare and Medicaid Programs; Reporting OASIS Data as Part of the CoPs for HHAs and Supporting Regulations in 42 CFR 484.11 and 484.20
0938-0760 Reporting OASIS Data as Part of the CoPs for HHAs and Supporting Regulations in 42 CFR 484.11 and 484.20
0938-0759 Medicare Beneficiary Information Needs: Supplement to the Medicare Current Beneficiary Survey (MCBS)
0938-0758 Hospice FacilityCost Report
0938-0757 Managed Care Organization Year 2000 Continuity and Contingency Planning (BCCP) Status Report
0938-0756 MSInteractive Survey Tool for www.medicare.gov
0938-0755 Oxygen Consumer Survey; Medical Equipment and Supplies Consumer Survey
0938-0754 Inpatient Psychiatric Services for Individuals Under Age 21 and Supporting regulations in 42 CFR 441.152
0938-0753 Medicare+Choice Program Requirements -- 42 CFR 422.000-422.700
0938-0752 Evaluation of the EverCare Demonstration Program
0938-0751 Medicare Current Beneficiary Survey: National Baseline Medicare Beneficiary Knowledge Supplement
0938-0750 Best Practices in Coordinated Care
0938-0749 On-Site Inspection for Durable Medical Equipment (DME) Supplier Location and Supporting Regulations in 42 CFR, Section 424.57 (CMS-R-263)
0938-0748 Medicare DMEPOS Competitive Bidding Demonstration: Site 2
0938-0746 Medicaid Disproportionate Share Hospitals/Institutions for Mental Disease
0938-0745 Quality Improvement System for Managed Care (QISMC) Standards and Guidelines
0938-0742 Managed Care Adjusted Community Rate (ACR) Proposal and Supporting Regulations in 42 CFR Sections 422.300-422.312
0938-0741 Medicare+Choice Disenrollment Form to Original Medicare and Supporting Regulations 422.66
0938-0740 Bounceback Form for Medicare and You on WWW.Medicare.Gov
0938-0739 SNF Resident Assessment MDS Data and Supporting Regulations in 42 CFR 413,337, 413.343, 424.32, and 483.20
0938-0738 National Medicare Education Program (NMEP) Community Survey of Medicare Beneficiaries
0938-0737 Call-Back Survey of Callers to the Medicare+Choice Toll-Free Hotline
0938-0736 Multi-State Evaluation of the Dual Eligible Demonstration
0938-0734 Use Agreement (DUA) Limited Data Set (LDS) Forms Research Identifiable Files (FIF) Forms (CMS-R-235)
0938-0733 Waiver Requirements and Solvency Standards for Provider-Sponsored Organizations -- 42 CFR 422.350-.390
0938-0732 The Medicare Managed Care CAHPS Survey and Supporting Regulations in 42 CFR 417.126 and 417.470
0938-0731 Quarterly Children's Health Insurance Program Statement of Expenditures for Title XXI (CMS-21 and 21B)
0938-0730 Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410, 405.430, 405.435, 405.440, 405.445, 405.455, 410.61, 415.110, and 424.24 (CMS-R-234)
0938-0727 Evaluation of the Oregon Medicaid Reform Demonstration: Phase II Adult Interview, Phase II Child Interview, Survey of Agency Providers
0938-0726 Evaluation of the Medicare Choices Demonstrations
0938-0725 Medicare Physician Communication Survey
0938-0723 The Medicare Integrity Program (MIP) Contractor Information Collection Requirements and Supporting Regulations as Contained in 42 CFR 421.310 and 421.312
0938-0722 Medicare+Choice Provider Sponsored Organization Waiver Request Form and Supporting Regulations at 42 CFR 422.370 through 422.378
0938-0721 Independent Diagnostic Testing Facility and Supporting Regulations Contained in 42 CFR 410.33
0938-0720 Development of an Assessment System for Post Acute Care
0938-0719 Mental Health Parity Act of 1996: Information Collection Requirements Contained in HCFA-2891-IFC -- 45 CFR 146.136
0938-0718 Research and Analytic Support for Implementing Performance Measurement in Medicare Fee for Service
0938-0717 Information Collection Requirements Referenced in 42 CFR Section 424.57: Additional DMEPOS Supplier Standards
0938-0715 End-Stage Renal Disease Managed Care Demonstration Evaluation
0938-0714 Procedures for Advisory Opinions Concerning Physicians Referrals and Supporting Regulations -- Sections 411.370 Through 411.389
0938-0713 Surety Bond Requirements for Home Health Agencies (HHA) and Supporting Regulations -- 42 CFR 441.16, 489.28, 489.66, and 489.67
0938-0712 Survey of Primary Caregivers for the District of Columbia's Managed Care Demonstration for Disabled and Special Needs Children
0938-0711 Managed Care Data Using the Uniform Institutional Providers Form and Supporting Statute 1853(a)(3) of the BBA
0938-0710 Evaluation of the Oregon Medicaid Reform Demonstration: Adult Interview, Child Interview, Pediatric Asthma Interview, Insulin- Dependent Diabetes Interview, Low Back Pain Interview Medical....
0938-0709 Data Collection for the Second Generation Social Health Maintenance Organization Demonstration
0938-0708 Evaluation of the State Medicaid Reform Demonstrations and Evaluation of the Medicaid Health Reform Demonstrations
0938-0707 Model Application Template for State Child Health Plan Under Title XXI of the Social Security Act, State Children's Health Insurance Program, and Model Application Template
0938-0705 Maximizing the Effective Use of Telemedicine: A Study of the Effects, Cost Effectiveness and Utilization Patterns of Consultations via Telemedicine
0938-0704 Data Collection Forms for a Project to Develop a Case-Mix Adjustment System for a National Home Health Prospective Payment Program
0938-0703 Information Collection Requirements Referenced in HIPAA, Title 1 for the Individual Market, Supporting Regulations at 45 CFR 148.120, 148.122, 148.124, 148.126, and 148.128, and Forms/....
0938-0702 Information Collection Requirements Referenced in HIPAA, Title 1, for the Group Market, Supporting Regulations at 45 CFR 146.111, 146.115, 146.117, 146.150, 146.152, 146.160, and 146.180, and...
0938-0701 Medicare Health Outcomes Survey (HOS) and Supporting Regulations at 42 CFR 422.152 (CMS-10203)
0938-0700 Incentive Arrangement Disclosure Form and Supporting Regulations 42 CFR 417.479, 417.500, 422.208, 422.210, 434.44, 434.67, 434.70, 1003.100, 1003.101, 1003.103, 1003.106
0938-0699 Notification Procedures for States Implementing Alternative Mechanisms in the Individual Health Insurance Market and Supporting Notice -- BPD-882-N
0938-0698 Hospital Standards for Potentially HIV Infectious Blood and Blood Products -- 42 CFR 482.27
0938-0697 Medicaid Report on Payables and Receivables (R-199)
0938-0694 Evaluation of the Per-Episode Home Health Prospective Payment Demonstration
0938-0693 Federally Qualified Health Center (FQHC) Survey
0938-0692 Medicare and Medicare Advantage Programs; Notification Procedures for Hospital Discharges: Important Message From Medicare (CMS-R-193)
0938-0691 Medicare Disproportionate Share Adjustment Procedures and Criteria and Supporting Regulations in 42 CFR 412.106
0938-0690 Granting and Withdrawal of Deeming Authority to National Accreditation Organizations and Supporting Regulations at 42 CFR 488.4-488.9, and 488.201
0938-0688 Conditions of Coverage for Organ Procurement Organizations (OPOs) and Supporting Regulations in 42 CFR, Section 486.304, 486.306, 486.307, 486.310, 486.316, 486.218, and 486.325
0938-0687 Maximizing the Effectiveness of Home Health Care: The Influence of Service Volume and Integration with Other Care Settings on Patient Outcomes
0938-0686 Granting and Withedrawal of Deeming Authority to Private Nonprofit Accreditation Organizations and of State Exemption Under State Laboratory Programs and Supporting Regs
0938-0685 Medicare Health Care Provider Enrollment Application and Supporting Regulations -- 42 CFR 405.2401; 410.40, .69; 491.2; 414.451, .52, .56, .60; 424.57, .73; 440.30
0938-0684 National Provider System
0938-0683 Evaluation of the Medicare Cataract Surgery Alternate Payment Demonstration
0938-0682 Data Collection and Analysis for Generating Procedure-Specific Cost Estimates
0938-0681 Evaluation of the Oregon Medicaid Reform Demonstration, Baseline Survey
0938-0680 Field Testing of the Uniform Needs Assessment Instrument (UNAI): Small-Scale Trial Phase 2
0938-0679 Durable Medical Equipment Regional Carrier, Certificates of Medical Necessity
0938-0678 Evaluation of Intermediate Care Facilities for Persons with Mental Retardation
0938-0677 Study of the Cost of Administering Childhood Immunizations -- HCFA-17-C-90379/3-1
0938-0676 Reconciliation of State Invoice and Prior Quarter Adjustment Statement and Supporting Regulations -- 42 CFR 447.500-42 CFR 447.550
0938-0675 Quality Assurance for Phase II of the Home Health Agency Prospective Payment Demonstration
0938-0674 Targetted Race and Ethnicity Survey
0938-0673 Medicaid Posteligibility Preprint
0938-0671 EVALUATION OF THE DRUG USE REVIEW DEMONSTRATIONS PROJECTS
0938-0670 Criteria for Medicare Coverage of Lung Transplants
0938-0669 DIALYSIS UNIT HEALTH CARE QUALITY IMPROVEMENT PROGRAM SURVEY
0938-0667 Information Collection Requirements Contained in BPD-393, Examination and Treatment for Emergency Medical Conditions and Women in Labor
0938-0665 MEDICARE TECHNICAL ADVISORY GROUP (M-TAG) BENEFICIARY SURVEY
0938-0664 EVALUATION OF PATIENT AND PHYSICIAN SATISFACTION WITH THE MEDICARE PARTICIPATING HEART BYPASS CENTER DEMONSTRATION
0938-0663 EXAMINATION AND TREATMENT OF EMERGENCY MEDICAL CONDITIONS AND WOMEN IN LABOR AND 42 CFR 489.24 ESSENTIALS OF PROVIDER AGREEMENT RESPONSIBILITIES OF MEDICARE PARTICIPATING....
0938-0662 Survey of Applicants to the Program of All-Inclusive Care for the Elederly (PACE)
0938-0660 VOLUNTARY "PARTNER/REGULATED ENTITY" CUSTOMER SURVEYS TO IMPLEMENT EXECUTIVE ORDER 12862 WITHIN HCFA
0938-0659 [Medicaid] Medicaid Drug Utilization Review (DUR) Program (CMS-R-153)
0938-0658 ESRD Network Business Proposal Forms
0938-0657 End-Stage Renal Disease (ESRD) Network Semi-Annual Cost Report Forms and Supporting Regulations in 42 CFR 405.2110 and 42 CFR 405.2112
0938-0656 EVALUATION OF MEDICARE SELECT AMENDMENTS
0938-0655 Clinical Laboratory Improvement Amendments (CLIA) Adverse Action Extract and Supporting Regulations at 42 CFr 493.1840
0938-0654 Post Laboratory Survey Questionnaire, Surveyor
0938-0653 Post Laboratory Survey Questionnaire--Laboratory, and Supporting Regulations in 42 CFR 493.1771, 493.1773, and 493.1777
0938-0652 VOLUNTARY CUSTOMER SURVEYS TO IMPLEMENT E.O. 12862 WITHIN THE HEALTH CARE FINANCE ADMINISTRATION (HCFA)
0938-0651 MEDICARE AND MEDICAID COVERAGE DATA BANK REPORTS
0938-0650 CLINICAL LABORATORY IMPROVEMENT AMENDMENTS (CLIA) FLEXIBLE SURVEY PROTOCOL FORM
0938-0649 BENEFICIARY SURVEY FORM
0938-0648 EVALUATION OF THE MEDICAID UNINSURED DEMONSTRATIONS
0938-0647 EVALUATION OF THE MEDICARE CASE MANAGEMENT DEMONSTRATION
0938-0646 OSCAR USERS QUESTIONNAIRE
0938-0644 Intake and Assessment Survey Package for the Community Nursing Organization Demonstration
0938-0642 STATE SURVEY AGENCY BUDGET/EXPENDITURE REPORT, STATE AGENCY CERTIFICATION WORKLOAD REPORT
0938-0641 GRANTEE DATA COLLECTION INSTRUMENT, ICA -- SECTION 4360
0938-0640 MEDIGAP COMPLAINT DATABASE
0938-0637 PRENATAL SERVICES AND ASSISTANCE SCREENING QUESTIONNAIRE
0938-0636 SURVEYOR SURVEY FOR THE HOME HEALTH AGENCY ASSESSMENT EVALUATION PROJECT
0938-0635 CONTRACTOR FINANCIAL REPORTS -- HCFA-750B
0938-0634 CONTRACTOR FINANCIAL REPORTS -- HCFA-750A
0938-0632 STATUS OF ACCOUNTS RECEIVABLE -- HCFA-751B
0938-0630 STATUS OF ACOUNTS RECEIVABLE
0938-0629 MONITORING AND EVALUATION OF THE MEDICARE CATARACT SURGERY ALTERNATE PAYMENT DEMONSTRATION
0938-0628 STUDY OF MEDICAID UTILIZATION MANAGEMENT INITIATIVES
0938-0627 Video Display Terminal (VDT) Operators' Eye Care Program
0938-0626 Electronic Funds Transfer Authorization Agreement (CMS-588)
0938-0625 EVALUATION OF MARYLAND ACCESS TO CARE PROGRAM
0938-0624 REQUEST FOR APPROVAL AS A HOSPITAL PROVIDER OF EXTENDED CARE SERVICES (SWING-BED) IN THE MEDICARE AND MEDICAID PROGRAMS
0938-0623 LONG TERM CARE PROGRAM AND MARKET CHARACTERISTICS STUDY
0938-0622 EVALUATION OF MEDICAID EXTENSION DEMONSTRATION
0938-0621 MEDICAID CAPITATED MANAGED CARE PROGRAM FOR SSI DISABLED
0938-0620 IMPACT OF HOME HEALTH CARE PLAN MANAGEMENT AND EVALUATION, HOME CARE QUALITY STUDIES -- TASK 3.1
0938-0619 MEDICARE CURRENT BENEFICIARY SURVEY, ROUND 5 OMB SUPPLEMENT
0938-0618 [Medicaid] Limitations on Provider Related Donations and Health Care Related Taxes; Medicaid and Supporting Regulations in 42 CFR 433.68 and 433.74 (CMS-R-148)
0938-0617 OUTPATIENT RESOURCE COSTING STUDY (18-C-901-23/3-01), DATA COLLECTION OF PROVIDERS OF OUTPATIENT SERVICES
0938-0616 CERTIFICATION RECOMMENDATION, CLIA LABORATORY
0938-0615 MEDICARE PHYSICIAN SURVEY FORM -- PILOT
0938-0613 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN THE REGULATION FOR HOME AND COMMUNITY-BASED SERVICES WAIVER FOR INDIVIDUALS AGE 65 OR OLDER
0938-0612 Information Collection Requirements (ICR) Contained in the Clinical Laboratory Improvement Amendments (CLIA) Regulations 42 CFR Part 493.801, 493.803, 493.1232, 493.1233, 493.1234,...
0938-0611 SCREENING MAMMOGRAPHY SERVICES DATA REPORT
0938-0610 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BPD-718: ADVANCE DIRECTIVES (MEDICARE AND MEDICAID)
0938-0609 MEDICARE INTERMEDIARY PART A AND PART B APPEALS REPORT
0938-0608 MEDICARE COVERAGE OF SCREENING MAMMOGRAPHY
0938-0607 CLINICAL LABORATORY IMPROVEMENT AMENDMENTS OF 1988, FEE COLLECTION -- 42 CFR SECTIONS 493.614, 493.633, AND 493.634
0938-0606 INTAKE AND FOLLOW-UP SURVEY OF MEDICARE BENEFICIARIES IN STAFF-ASSISTED HOME DIALYSIS DEMONSTRATION
0938-0605 PHYSICIAN PAYMENT DIFFERENTIALS IN GROUP PRACTICES SURVEY
0938-0604 State Survey Agency List of Positions and Schedule of Equipment Purchases
0938-0603 ATTENDING PHYSISIANS PARENTERAL/ENTERAL NUTRITION CERTIFICATION OF MEDICAL NECESSITY
0938-0602 EVALUATION OF THE OBRA 1967 MEDICARE PAYMENT FOR THERAPEUTIC SHOES BENEFICIARY SURVEY
0938-0601 PRECLEARANCE: INFORMATION COLLECTION FOR COMMUNITY NURSING ORGANIZATION DEMONSTRATION
0938-0600 Medicare Credit Balance Reporting Requirements and Supporting Regulations in 42 CFR 405.371, 405.378, and 413.20
0938-0599 CLIA Budget/Expenditure Report, CLIA Planned Workload Report
0938-0597 TASK 4: HOME CARE WORKER SUPPLY AND HOME CARE QUALITY STUDIES
0938-0595 MEDICAID PROVIDERS TAXES AND DONATIONS PROGRAMS APPLICATION
0938-0594 MEDICARE SUPPLIER NUMBER APPLICATION
0938-0593 DISCHARGE AND FOLLOW-UP PATIENT INTERVIEWS (EVALUATION OF THE HOME HEALTH PROSPECTIVE PAYMENT DEMONSTRATION)
0938-0592 TASK 3.2 ACCESS TO AND ADEQUACY OF PARAPROFESSIONAL HOME CARE - HOME CARE QUALITY STUDIES
0938-0591 COST REPORT FORMAT FOR PEER REVIEW ORGANIZATIONS
0938-0590 HOME CARE AGENCY SCREENING INSTRUMENT AND FOLLOW-UP TELEPHONE INTERVIEW
0938-0588 A POLICY STUDY OF THE COST-EFFECTIVENESS OF INSTITUTIONAL SUBACUTE CARE ALTERNATIVES AND SERVICES
0938-0587 EVALUATION OF THE HOME HEALTH PROSPECTIVE PAYMENT DEMONSTRATION
0938-0586 PHYSICIAN FINANCIAL INTEREST IN CLINICAL LABORATORIES SURVEY FORM
0938-0585 APPLICATION TO PROVIDE COMMUNITY SUPPORTED LIVING ARRANGEMENTS (CSLA) SERVICES
0938-0583 Survey Team Composition and Workload Report
0938-0582 State Drug Rebate, Medicaid
0938-0581 PARTS A AND B APPLICATION FORMS FOR PROVISIONAL CERTIFICATES
0938-0580 Criteria for Medicare Coverage of Liver Transplants
0938-0579 Business Proposal Forms For Quality Improvement Organizations (QIOs) (CMS-718-721)
0938-0578 Medicaid Drug Rebate Program, Manufacturers
0938-0576 PRECLEARANCE - PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) EVALUATION
0938-0575 Medicare Physician Fee Schedule Geographic Practice Expense Index (GPCI)
0938-0574 END STAGE RENAL DISEASE (ESRD) MEDICAL CASE REVIEW
0938-0573 MEDICARE GEOGRAPHICAL CLASSIFICATION REVIEW BOARD PROCEDURES AND CRITERIA
0938-0572 TERMINATION OF ENROLLMENT REGULATION -- BPD-306
0938-0571 ESTABLISHING PROCEDURES FOR TRANSMITTING INFORMATION BETWEEN MEDICARE CARRIERS AND MEDICARE SUPPLEMENTAL INSURERS
0938-0570 PATIENT INTAKE DATA FORM FOR THE NATIONAL HOME HEALTH AGENCY PROSPECTIVE PAYMENT DEMONSTRATION
0938-0569 AGENCY CHARACTERISTICS FORM FOR THE NATIONAL HOME HEALTH AGENCY PROSPECTIVE PAYMENT DEMONSTRATION
0938-0568 MEDICARE CURRENT BENEFICIARY SURVEY: ROUNDS 7-10
0938-0567 Request for Part B Medicare Hearing by an Administrative Law Judge and Supporting Regulations in 42 CFR 498, Subpart D and E
0938-0566 Medicare -- ICR in BPD-458F, Section 411.408(d)(2) and (f)
0938-0565 IRS/SSA/CMS Data Match and Supporting Regulations in 42 CFR Sections 411.20-411.206
0938-0564 Proper Claim Not Filed and Supporting Regulation Contained in 42 CFR 411.32(c)
0938-0563 STATE SURVEY AGENCY BUDGET REQUEST - LONG-TERM CARE FACILITY WORKLOAD
0938-0562 STATE SURVEY AGENCY QUARTERLY EXPENDITURE REPORT - LONG-TERM FACILITY WORKLOAD
0938-0561 PRECLEARANCE: IMPLEMENTATION AND EVALUATION OF THE HOME HEALTH PROSPECTIVE PAYMENT DEMONSTRATION
0938-0560 UNIFORM COST REPORT DEMONSTRATION--VALIDATION QUESTIONNAIRE
0938-0559 HOSPITAL AND HOSPITAL HEALTH CARE COMPLEX COST REPORT, FORM HCFA-2552-DEMO
0938-0558 INFORMATION COLLECTION REQUIREMENTS AT 42 CFR 411.54(C)(1) ITEMIZED STATEMENT OF HOSPITAL CHARGES
0938-0557 TAX EQUITY AND FISCAL RESPONSIBILITY ACT (TEFRA) HMO AND CMP PROGRAM EVALUATION BENEFICIARY SURVEY
0938-0556 INFORMATION COLLECTION REQUIREMENTS IN BPD-311-F, REVALUATION OF ASSETS
0938-0555 INFORMATION COLLECTION REQUIREMENTS IN BQC-64-F, STATE PLAN REQUIREMENTS AND OTHER PROVISIONS RELATING TO THIRD-PARTY LIABILITY (TPL) PROGRAMS
0938-0554 INFORMATION COLLECTION REQUIREMENTS FOR REQUESTING COST AVOIDANCE WAIVERS AS PROVIDED FOR IN BQC-64
0938-0553 INFORMATION COLLECTION REQUIREMENTS FOR THE THIRD-PARTY LIABILITY (TPL) ACTION PLAN AS PROVIDED FOR IN BQC-64
0938-0552 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-483, SECTION 403.408 DEMONSTRATION COST REPORT
0938-0550 PRECLEARANCE: HOME CARE QUALITY STUDIES
0938-0549 MEDICARE: SUPPORTING STATEMENT FOR REQUEST FOR MEDICAL REVIEW INFORMATION FOR PART B OUTPATIENT BILLS
0938-0548 MEDICARE - HMO REPORTING FORMS
0938-0547 MEDICARE - PILOT STUDY - OUTCOMES MANAGEMENT - HMOS
0938-0546 MEDICARE INFLUENZA VACCINE DEMONSTRATION
0938-0544 Survey Report Form Clinical Laboratory Improvement Amendments (CLIA) and supporting regulations in 42 CFR 493.1-493.2001
0938-0543 PILOT TEST OF A HOME HEALTH AGENCY FUNCTIONAL ASSESSMENT INSTRUMENT
0938-0542 MEDICARE - INFORMATION COLLECTION REQUIREMENTS FOR HOME HEALTH AGENCIES & HOSPICES AT 42 CFR 421.117(E) AND (F) AND SECTION 140 OF THE HHA & HOSPICE MANUALS, ETC.
0938-0538 COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY INFORMATION COLLECTION REQUIREMENTS IN 42 CFR 485.56, 485.58, 485.60, 485.64, 485.66, AND 405.262
0938-0537 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-408-F PAYMENT FOR KIDNEYS SENT TO FOREIGN COUNTRIES OR TRANSPLANTED IN PATIENTS OTHER THAN MEDICARE BENEFICIARIES
0938-0535 REFUNDING OF FEDERAL SHARE OF OVERPAYMENTS MADE TO MEDICAID PROVIDERS
0938-0534 ATTENDING PHYSICIANS CERTIFICATION OF MEDICAL NECESSITY "MEDICARE" FOR HOME OXYGEN THERAPY
0938-0533 MEDICARE THERAPEUTIC SHOES FOR SEVERE DIABETIC FOOT DISEASE DEMONSTRATION PRESCRIPTION FORM
0938-0532 PRECLEARANCE - EVALUATION OF THE MEDICARE ALZHEIMER'S DISEASE DEMONSTRATION
0938-0531 PRO Reporting Forms
0938-0528 SECTION 4005(D) OBRA: EXPANSION OF SWING BED PROGRAM
0938-0527 MEDICARE, MEDICAID, AND CLINICAL LABORATORIES IMPROVEMENT ACT (CLIA) PATIENT CONFIDENTIALITY RULES, 42 CFR 74.53(B) (C), 405.1316(F)(2)(3) AND 441.16(A)(B) AND (C)
0938-0526 Quality Improvement (formerly Peer Review) Organization Contracts: Solicitation of Statement of Interest from In-State Organizations, General Notice and Supporting...
0938-0525 SUPPLEMENTAL SURVEY MECHANISM
0938-0524 HMO/CMP DISENROLLMENT SURVEY FORM
0938-0523 Information Collection Requirements Contained in 42 CFR 447.253
0938-0522 WORKSHEET FOR SECTION 1867 OF THE SOCIAL SECURITY ACT: EXAMINATION AND TREATMENT FOR EMERGENCY MEDICAL CONDITIONS AND WOMEN IN ACTIVE LABOR
0938-0521 MEDICAID - INFORMATION COLLECTION REQUIREMENTS IN HSQ-127-F 42 CFR SECTIONS 442.114(A), 441.115(A) AND 442.116(A)(C) AND (D)
0938-0520 MEDICARE - HMO REPORTING FORMS
0938-0519 Medicare Home Health Quality Assurance Demonstration -- 42 CFR 484
0938-0518 BENEFICIARY INCENTIVES TO PARTICIPATE IN ALTERNATIVE HEALTH PLANS
0938-0517 DATA COLLECTION TO ESTABLISH A FEE SCHEDULE FOR THE SERVICES OF CRNAS
0938-0516 PRE CLEARANCE FOR: A988 PHYSICIANS PRACTICE COSTS AND INCOMES SURVEY
0938-0515 MEDICARE - EVALUATION OF OPA MARKETING EDUCATIONAL PROMOTION SURVEY QUESTIONNAIRE
0938-0514 PILOT TEST - HOME HEALTH AGENCY SURVEY FORMS
0938-0513 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-356-F "LIMITS ON PAYMENTS FOR DRUGS"
0938-0512 Organ Procurement Organization's Request for Designation and Supporting Regulations in 42 CFR 486.304, 486.306, 486.307
0938-0511 Skilled Nursing Facility Prospective Payment System Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24
0938-0510 MEDICARE - INFORMATION COLLECTION REQUIREMENTS IN SOM SECTION 2280 AND ROM - SECTION - 5223 DIALYSIS AT HOME PROGRAM
0938-0509 THE HOME AND COMMUNITY-BASED SERVICES WAIVERS MANUAL INSTRUCTIONS
0938-0508 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-371-FC, APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT PARTICIPATION IN MEDICARE
0938-0507 Medicare Managed Care Disenrollment Form
0938-0506 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN 42 CFR 416.43 AND 416.47
0938-0505 MISCELLANEOUS CONFORMING AMENDMENTS
0938-0504 INFORMATION COLLECTION REQUIREMENTS IN BPO-41P, ADJUSTMENT OF FEDERAL SHARE FOR UNCASHED OR CANCELLED CHECKS, 45 CFR SECTIONS 201.5 (A)(3), 201.67 (C)(2) & 201.67(D)(2)
0938-0503 PRECLEARANCE FOR: EVALUATION OF TEFRA HMO AND CMP PROGRAM (PRECLEARANCE NO. 008)
0938-0502 Medicaid: Determining Third-Party Liability (TPL) State Plan Preprint and Supporting Regulations in 42 CFR 433.138
0938-0501 Medicare Qualification Statement for Federal Employees and Supporting Regulations in 42 CFR 406.15
0938-0500 EVALUATION OF THE MEDICARE COMPETITION DEMONSTRATIONS
0938-0499 RECORDKEEPING REQUIREMENTS CONTAINED IN PROVIDER REIMBURSEMENT MANUAL SECTIONS 2198 AND 2746
0938-0497 "MEDICAID" INFORMATION COLLECTION REQUIREMENTS IN BPO-47-FN, MMIS REQUIREMENTS FOR PHYSICIAN AND SUPPLIER SERVICES
0938-0496 "MEDICARE" NEW YORK BILLING FORM
0938-0492 MEDICARE ESRD OUTCOME SURVEY REPORT FORM
0938-0491 MEDICARE - PRO REPORTING FORMS
0938-0490 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-362-PN CRITERIA FOR MEDICARE COVERAGE OF HEART TRANSPLANTS
0938-0489 INFORMATION COLLECTION REQUIREMENTS FOR SOLE COMMUNITY HOME HEALTH AGENCIES AT 42 CFR 424.22(B) (2), (F), AND (G)
0938-0488 MEDICAID - INFORMATION COLLECTION REQUIREMENTS IN ALTERNATIVE SANCTIONS FOR LONG TERM CARE FACILITIES, 42 CFR 442.118(B)
0938-0487 Systems Performance Review (SPR)
0938-0486 Request for Part A Medicare Hearing by an Administrative Law Judge and Supporting Regulations in 42 CFR 498 Subpart D and E
0938-0485 MEDICARE/MEDICAID HOSPITAL SWING-BED SURVEY REPORT FORM
0938-0484 EMERGENCY AND FOREIGN HOSPITAL SERVICES--BENEFICIARY STATEMENT IN CANADIAN TRAVEL CLAIMS
0938-0483 INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED PROTOTYPE SURVEY REPORT FORM
0938-0482 MEDICARE - ELECTION TO RECALCULATE MEDICARE REIMBURSEMENT BASED ON 42 CFR 405.457
0938-0481 Sterilization Regulations and Consent Form
0938-0479 TITLE XIX SUPERIOR UTILIZATION REVIEW (UR) SYSTEM WAIVER REQUEST INFORMATION COLLECTION REQUIREMENT-SECTIONS 9320-9330 OF STATE MEDICAID MANUAL
0938-0478 THE LONG TERM CARE REQUEST FOR CERTIFICATION
0938-0477 PAYMENT ADJUSTMENT FOR SOLE COMMUNITY HOSPITALS, 42 CFR 412.92
0938-0476 HOSPICE CORE SERVICE: NURSING (HOSPICE MANUAL)
0938-0475 Hospice Core Service: Nursing Information Collection
0938-0473 INFORMATION COLLECTION REQUIREMENTS IN BERC-240-F, RECOGNITION OF STATE REIMBURSEMENT CONTROL SYSTEM
0938-0472 Requirement to Disclose HMO Financial Information to Members and Supporting Regulations in 42 CFR 417.124
0938-0471 42 CFR PART 110 - (NPRM) HEALTH MAINTENANCE ORGANIZATIONS
0938-0470 The Application for Federal Qualification (CMS 901A) Regulations in 42 CFR Section 417.140 and the Medicare Health Care Prepayment Plan Application (CMS 901D) in 42 CFR 417.800.
0938-0469 The Fiscal Soundness Reporting Requirements (FSRR)
0938-0467 [Medicaid] Income and Eligibility Verification System Reporting and Supporting Regs. (CMS-R-74)
0938-0465 PROCEDURES FOR DETERMINING WHETHER PROVIDERS, PRACTITIONERS, OR OTHER SUPPLIERS OF SERVICES ARE LIABLE FOR_CERTAIN UNCOVERED SERVICES, MEDICARE -- BERC-273F
0938-0464 MEDICAID PROGRAM CHARACTERISTICS QUESTIONNAIRE
0938-0463 Skilled Nursing Facility and Skilled Nursing Facility Health Care Complex Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24
0938-0461 MEDICARE - INFORMATION COLLECTION REQUIREMENTS IN HCFA-PUB. 14-3 CARRIER MANUAL SECTIONS 2070.2, 3060.2.D., 4110.2 AND 4110.4 - PHYSICIAN/SUPPLIER BACKGROUND INFORMATION
0938-0460 INFORMATION COLLECTION REQUIREMENT IN HCFA-PUB. 14-3 SECTION 2120.1 CARRIER MANUAL-AMBULANCE SERVICE
0938-0459 INFORMATION COLLECTION REQUIREMENTS IN BPO-500-F, THIRD-PARTY LIABILITY FOR MEDICAL ASSISTANCE, FFP RATES FOR SKILLED PROFESSIONAL MEDICAL PERSONNEL AND SUPPORTING STAFF
0938-0458 UNIFORM HOSPITAL BILL (HCFA-1450) AND RELATED ELECTRONIC MEDIA CLAIM FORMAT - MEDICAID SYSTEM REQUIREMENTS
0938-0457 SECTION 2405.3 OF THE PROVIDER REIMBURSEMENT MANUAL - SINGLE DAY METHOD FOR COUNTING INTERNS AND RESIDENTS TO FACILITATE PAYMENT OF INDIRECT MEDICAL EDUCATION COSTS
0938-0456 Indirect Medical Education (IME) and Supporting Regulations 42 CFR 412.105 (CMS-R-64)
0938-0454 Physician Certifications/Recertifications in Skilled Nursing Facilities, (SNF's)
0938-0452 MEDICARE, CARRIER APPEAL REPORT
0938-0451 JCAH HOSPICE MAIL SURVEY QUESTIONNAIRE
0938-0450 EVALUATION OF SOCIAL/HEALTH MAINTENANCE ORGANIZATION (S/HMO) DEMONSTRATION
0938-0449 [Medicaid] Home & Community Based Waiver Requests and Supporting Regulations; 42 CFR 440.180 and 441.300 - 441.310 (CMS-8003)
0938-0448 ESRD DEATH NOTIFICATION
0938-0447 MEDICARE: ESRD FACILITY SURVEY
0938-0446 RECIPIENT, USE AND EXPENDITURES FOR MEDICAID ENROLLEES COVERED UNDER SECTION 1619(A) AND (B) OF THE SOCIAL SECURITY ACT
0938-0445 Quality Improvement Organization (QIO) Assumption of Responsibilities and Supporting Regulations (CMS-R-71)
0938-0444 INFORMATION COLLECTION REQUIREMENTS IN HSQ-109-F, PEER REVIEW ORGANIZATION SANCTIONS, 42 CFR 474.36(B), 474.38(A), (B), & (C), 474.39(A) & (B), AND 474.40(A) AND (B)
0938-0443 PRO RECONSIDERATIONS AND APPEALS IN 42 CFR 473.18 (A) AND (B), 473.34 (A) AND (B), 47.36 (A) AND (B) AND 473.42 (A)
0938-0442 MMIS - CONDITION OF APPROVAL AND REAPPROVAL AND PROCEDURES FOR REDUCTION OF FFP, 42 CFR 433.112, 433.116 AND 433.117
0938-0441 PROVIDER OVERPAYMENT REPORT
0938-0440 PRO SEMIANNUAL RESOURCES ALLOCATION REPORT
0938-0439 PHYSICIAN/SUPPLIERS OVERPAYMENT REPORT
0938-0438 INFORMATION COLLECTION REQUIREMENTS CONCERNING CLAIMS PROCESSING ASSESSMENT SYSTEM (CPAS), HCFA R-91, HCFA-331, HCFA-503, & CURRENTLY APPROVED HCFA-R-93 TO BE CONSOLIDATED
0938-0437 COURT ORDERED REGULATIONS REGARDING PROSPECTIVE PAYMENT AMOUNTS AND ADMINISTRATIVE REVIEW
0938-0436 Pacemaker Related Data
0938-0434 AMBULATORY SURGICAL CENTER PAYMENT RATE SURVEY
0938-0433 INTERMEDIARY'S REQUEST TO HOSPITALS FOR MEDICAL INFORMATION ON OUTPATIENT CLAIMS
0938-0432 NATURE, PROCESS, AND MODES OF HOSPICE CARE DELIVERY HOSPICE SURVEY PROFILE AND HOSPICE ASSESSMENT AND SURVEY
0938-0431 INFORMATION COLLECTION REQUIREMENTS IN BOC-18-F, CLAIMS PROCESSING ASSESSMENT SYSTEM (CPAS)
0938-0430 NATIONWIDE EVALUATION OF MEDICAID COMPETITION DEMONSTRATIONS--MEDICAID CONSUMER SURVEY
0938-0429 INFORMATION COLLECTION REQUIREMENT IN 42 CFR SECTION 447.53(E) IMPOSITION OF COST-SHARING CHARGES UNDER MEDICAID
0938-0428 STATE MEDICAID MANUAL, PART 3, ON ASSIGNMENT OF RIGHTS
0938-0427 PRECLEARANCE FOR: COMPETITIVE BIDDING FOR DURABLE MEDICAL EQUIPMENT DEMONSTRATION (NO. 003)
0938-0426 Information Collection Requirements in HSQ-110, Acquisition, Protection and Disclosure of Peer Review Organization Information and Supporting Regulations in 42 CFR, Section 480.104, 480.105,..
0938-0425 PRECLEARANCE FOR: PROSPECTIVE PAYMENT AND ANALYTICAL SUPPORT STUDIES
0938-0423 PRECLEARANCE: EVALUATION OF THE CLINICAL LABORATORY SERVICES DEMONSTRATION
0938-0422 COVERAGE OF OXYGEN FOR USE IN A PATIENT'S HOME - BERC-024 FNC AND MANUAL INSTRUCTIONS, "MEDICARE"
0938-0421 PRECLEARANCE: DESIGN AND EVALUATION OF THE HOME HEALTH AGENCY PROSPECTIVE PAYMENT DEMONSTRATION
0938-0419 ADMISSION AND QUALITY OBJECTIVE PROGRESS REPORTS
0938-0418 QUARTERLY ACUTE CARE GENERAL HOSPITAL REPORT SUMMARY AND THE QUARTERLY SPECIALTY HOSPITAL REVIEW REPORTING SUMMARY
0938-0414 MEDICAID STATE AGENCY THIRD PARTY LIABILITY INVENTORY FORM
0938-0413 REPORT OF PRO REVIEW ACTIVITY
0938-0408 Methodology for Estimating Waiver Costs of HCFA Demonstration Projects
0938-0407 ELECTRONIC MEDIA CLAIM (EMC)/HARD COPY (HC) STUDY
0938-0406 INFORMATION COLLECTION REQUIREMENTS IN BERC-247-F, PAYMENTS TO HEALTH MAINTENANCE ORGANIZATIONS AND COMPETITIVE MEDICAL PLANS, R-29
0938-0405 RECONSIDERATION DETERMINATION AND SANCTION REPORT
0938-0404 SKILLED NURSING FACILITY SURVEY FORM
0938-0402 STATEMENT OF CUMULATIVE EXPENDITURES FOR DEMONSTRATION PROJECTS (EXPENDITURE REPORT)
0938-0400 PATIENT CARE AND SERVICES SURVEY REPORT FORM AND SKILLED NURSING FACILITY SURVEY FORM
0938-0399 MEDICARE PROGRAM CARRIER PERFORMANCE REPORT
0938-0397 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN 42 CFR, SECTIONS 447.413 AND 447.415 (BPO-07-F)
0938-0396 PRECLEARANCE: NONCERTIFIED HOSPICE COST ANALYSIS
0938-0395 HEALTH FACILITY LICENSURE AND CERTIFICATION DIRECTORS SURVEY QUESTIONNAIRE
0938-0394 DIALYSIS PATIENT QUESTIONNAIRE
0938-0393 HOME HEALTH AGENCY COST REPORT, SUPPLEMENT K
0938-0392 HOSPICE COST REPORT AND DATA FORM
0938-0391 Statement of Deficiencies and Plan of Correction and Supporting Regulations Contained in 42 CFR 488.18, 488.26, and 488.28
0938-0390 Post-Certification Revisit Report
0938-0389 SURVEY OF SELF INSURED PLANS
0938-0387 SCHEDULE OF NET HOURS AVAILABLE
0938-0386 MEDICARE, INFORMATION COLLECTION REQUIREMENTS IN 405.2112, 405.2123, 405.2136, 405.2137, 405.2138, 405.2139, 405.2140, AND 405.2171
0938-0385 PRECLEARANCE: EVALUATION OF SOCIAL/HEALTH MAINTENANCE ORGANIZATION (S/HMO) DEMONSTRATION
0938-0384 QUARTERLY PERIODIC INTERIM PAYMENT (PIP) REPORT
0938-0383 Medicare: Information on Provider Refunds and Supporting Regulations in 42 CFR 489.40-41
0938-0382 Medicare/Medicaid Hospital Surveyor's Worksheet and Supporting Regulations at 42.C.F.R. 488.26 and 442.30
0938-0381 REPAYMENT REQUEST DOCUMENTS - HOSPITAL, SNF, HHA
0938-0380 Hospital Request for Certification in the Medicare/Medicaid Program
0938-0379 HOSPICE SURVEY REPORT FORM
0938-0378 The Medicare/Medicaid Psychiatric Hospital Survey Data Contained in 42 CFR and Supporting Regultions in 42 CFR 482.60, 482.61, and 482.62
0938-0377 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-297-FC & RELATED INSTRUCTIONS IMPLEMENTING THE U.S. DISTRICT COURT'S DECISION IN LYNCH V. RANK
0938-0376 MEDICARE HISTOCOMPATIBILITY TESTING LABORATORIES SURVEY REPORT FORM
0938-0373 MEDICARE PHYSICIAN OR SUPPLIER AGREEMENT
0938-0372 ESRD Beneficiary Selection and Supporting Regulations Contained in 42 CFR 414.330
0938-0371 INTERMEDIARY BENEFIT PAYMENT REPORT
0938-0370 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN 442.307, 442.308, 442.309, 442.313, 442.314, 442.318, 442.319, AND 442.320, 442.311-CONDIT. OF PARTICIPAT. FOR INTERMED. FAM.
0938-0368 INFORMATION COLLECTION REQUIREMENTS IN 42 CFR PART 405.1315, 1316, AND 1317 CONDITIONS OF PARTICIPATION FOR LABORATORIES
0938-0366 ITERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED, CONDITIONS OF PARTICIPATION, ICF/MR
0938-0365 MEDICARE - INFORMATION COLLECTION REQUIREMENTS INCLUDED IN "CONDITIONS OF PARTICIPATION OF HOME HELATH AGENCIES"
0938-0364 INFORMATION COLLECTION REQUIREMENTS IN 405.1121, 405.1124, 405.1136, & 405.1137-CONDITIONS FOR PARTICIPATION FOR SNFS 405.1122, 405.1123, 405.1125, 405, 1126, 405.1127, 405.1128
0938-0361 MONTHLY CONTRACTOR FINANCIAL REPORT (HCFA 1522)/CONTRACTOR DRAWS ON LETTER OF CREDIT (HCFA 1521)
0938-0360 MEDICARE END STAGE RENAL DISEASE FACILITY SURVEY REPORT
0938-0359 MEDICARE: MEDICAL RECORDS REVIEW UNDER PPS
0938-0358 STATE AGENCY WORK SHEETS FOR VERIFYING EXCLUSIONS FROM THE PROSPECTIVE PAYMENT SYSTEM
0938-0357 PLAN OF TREATMENT AND HOME HEALTH CERTIFICATION FORM, MEDICAL INFORMATION FORM, ADDENDUM TO THE POT AND MIF FOR, AND INTERMEDIARY MEDICAL INFORMATION REQUEST
0938-0356 HCFA FORMS AND MANUAL ORDER
0938-0355 MEDICARE - HOME HEALTH AGENCY - REQUEST FOR CERTIFICATION IN THE MEDICARE/MEDICAID PROGRAM AND THE HOME HEALTH SURVEY REPORT FORM
0938-0354 INFORMATION COLLECTION IN EARLY & PERIODIC SCREENING, DIAGNOSIS & TREATMT. PROG. REG. (BERC-506-F), SEC. 441.56(A) (2)(I)-(IV), 56(D), 58(B), 60(A)(4)(5), & 61(A)
0938-0351 INFORMATION COLLECTED FROM FISCAL INTERMEDIARIES AND CARRIERS - FINANCIAL COLLECTIONS CATEGORY
0938-0350 MEDICARE CONTRACTOR ADMINISTRATIVE BUDGET AND COST REPORTING SYSTEM FORMS
0938-0349 SURVEY OF SEC. 2176 HOME & COMMUNITY BASED MEDICAID WAIVER PROGRAMS (SURVEY FOR THE DEVELOPMENTALLY DISABLED & CHRONICALLY MENTALLY ILL) - SURVEY OF THE IE OR OTHER PDP
0938-0347 HOSPITAL WAGE INDEX SURVEY
0938-0346 MEDICARE/MEDICAID HEALTH CARE FACILITY SURVEY AND CERTIFICATION FORMS
0938-0345 [Medicaid] Transformed - Medicaid Statistical Information System (T-MSIS) (CMS-R-284)
0938-0344 MEDICAID ELIGIBILITY QUALITY CONTROL - INFORMATION COLLECTION REQUIREMENTS IN 42 CFR 431.804(D)(3) AND (4)
0938-0342 1984 LONG-TERM CARE SURVEY
0938-0341 REPORT OF MEDICAL REVIEW ACTIVITY
0938-0340 MEDICAID QUALITY CONTROL (MQC) DISPOSITION LIST
0938-0339 42 CFR 433.113, FFP FOR OPERATION OF MECHANIZED CLAIMS PROCESSING AND INFORMATION RETRIEVAL SYSTEMS
0938-0338 Medicare and Medicaid Programs: Conditions of Participation for Portable X-ray Suppliers (CMS-R-43)
0938-0337 INFORMATION COLLECTION REQUIREMENTS IN 42 CFR 405.460 EXCEPTIONS TO COST LIMITS
0938-0336 INFORMATION COLLECTION REQUIREMENTS IN 42 CFR, PART 405.1722, 1725, 1736 - CONDITIONS OF PARTICIPATION FOR OUTPATIENT CLINICS
0938-0334 Medicare and Medicaid Programs: Conditions for Certification for Rural Health Clinics and Conditions for Coverage for FQHCs in 42 CFR Part 491 (CMS-R-38)
0938-0328 INFORMATION COLLECTION REQUIREMENTS IS 42 CFR PART 482 HOSPITAL CONDITIONS OF PARTICIPATION
0938-0326 INFORMATION REQUIREMENT RELATING TO REGULATION BPP-504- MEDICAID PROGRAM CONTRACTS WITH HMO'S AND PREPAID HEALTH PLANS
0938-0325 STATISTICAL REPORT ON MEDICAL CARE: RECIPIENTS, PAYMENTS AND SERVICES
0938-0313 Hospice Request for Certification in the Medicare Program and Supporting Regulations contained in 42 CFR Part 489.11 and 489.20
0938-0312 RECALCULATION OF CASE-MIX INDEX BASED ON TOTAL MEDICARE DISCHARGES
0938-0310 MQC STATISTICAL TABLES
0938-0309 INFORMATION COLLECTION REQUIREMENTS IN REGULATIONS SECTION 405.476(B) SOLE COMMUNITY HOSPITAL EXCEPTION (PROSPECTIVE PAYMENT, BERC-263)
0938-0308 INFORMATION COLLECTION REQUIREMENTS IN REGULATIONS SECTION 405.476(D) SOLE COMMUNITY HOSPITAL REQUEST FOR ADDITIONAL PAYMENT (PROSPECTIVE PAYMENT, BERC-263)
0938-0306 INFORMATION COLLECTION REQUIREMENTS IN REG. SEC. 405.1627 & 405.1629, PHYSICIAN CERTIFICATION & RECERTIFICATION (PROSPECTIVE PAYMENT REG, BERC-263)
0938-0305 INFORMATION COLLECTION REQUIREMENTS CONTAINED IN REGULATION SECTION 405.1042(C), HOSPITAL UTILIZATION REVIEW PLAN (PROSPECTIVE PAYMENT, BERC-263)
0938-0304 INFORMATION COLLECTION REQUIREMENTS IN REGULATION 489.23(B) AND (C) (WAIVER OF REQUIREMENTS TO BILL NON-PHYSICIAN SERVICES ON PART A-PROSPECTIVE PAYMENT, BERC-263)
0938-0302 Information Collection Requirements in the Hospice Conditions for Coverage. The following regulations are affected: 42CFR 418.22; 418.24; 418.28; 418.56(b),(e)(1),(e)(3); 418.58;......
0938-0301 PROVIDER COST REPORT REIMBURSEMENT QUESTIONNAIRE, MEDICARE
0938-0300 Quality Control of Negative Case Actions (NCA)
0938-0298 PROFESSIONAL STANDARDS REVIEW ORGANIZATION ROUTINE FEDERAL REPORTING REQUIREMENTS
0938-0296 REQUEST FOR EXCEPTION TO COMPOSITE RATE FOR OUTPATIENT DIALYSIS SERVICES, PROVIDER REIMBURSEMENT MANUAL, SECTION 2721, 2722, 2725
0938-0295 FREEDOM OF CHOICE: WAIVERS OF AND EXCEPTIONS TO STATE PLAN REQUIREMENTS, 42 CFR 431.54(F)(3) AND 431.55(B)(2)
0938-0294 PRECLEARANCE: EVALUATION OF THE MEDICAID COMPETITION DEMONSTRATION
0938-0291 EARLY PERIODIC SCREENING DIAGNOSTIC AND TREATMENT (EPSDT) REPORT
0938-0290 NATIONAL (RURAL) SWING BED PROGRAM EVALUATION
0938-0289 MEDICARE EVALUATION OF THE MEDICARE COMPETITION SURVEY QUESTIONNAIRE
0938-0288 TRANSMITTAL OF SUPPLEMENTARY INFORMATION FOR DETERMINATION OF THE TARGET AMOUNT UNDER THE MEDICARE PROSPECTIVE PAYMENT SYSTEM
0938-0287 WITHHOLDING THE FEDERAL SHARE SECTION 2104 OF P.L. 97-35
0938-0286 EVALUATION OF MEDICARE AND MEDICAID ALCOHOLISM SERVICES DEMONSTRATION
0938-0285 PAYMENT FOR PHYSICIANS' SERVICES FURNISHED IN HOSPITALS, SNFS, AND CORFS
0938-0284 SURVEY OF PHYSICIAN PRACTICE COSTS AND INCOMES
0938-0282 QUARTERLY SHOWING VALIDATION SURVEYS
0938-0281 EVALUATION OF ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
0938-0279 UNIFORM HOSPITAL BILL
0938-0278 MEDICARE HHA PROSPECTIVE PAYMENT DEMONSTRATION
0938-0275 PSRO ROUTINE FEDERAL REPORTING REQUIREMENTS, HCFA 111, 121-B 135, 153, SF 269
0938-0273 Request for Certification in the Medicare and/or Medicaid Program to Provide Outpatient Physical Therapy (OPT) and/or Speech Pathology Services (OSP)- Initial and Extension Site Requests (CMS-381)
0938-0272 [Medicaid] Annual Report on §1915(c) Home and Community-Based Services Waivers (CMS-372(S))
0938-0271 STATEMENT OF REIMBURSABLE COSTS
0938-0270 The Financial Statement of Debtor and Supporting Regulations in 42 CFR, Section 405.376 (CMS-379 )
0938-0269 Request for Accelerated Payments Supporting Regulations in 42 CFR, section 412.116 & 413.64
0938-0268 ANNUAL REPORT ON WAIVERS FOR HOME AND COMMUNITY BASED SERVICES
0938-0267 COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY SURVEY PROCESS AND ELIGIBILITY FORM
0938-0266 AMBULATORY SURGICAL CENTER: CERTIFICATION AND SURVEY REPORT
0938-0264 MEDICARE SUPPLEMENTAL POLICIES
0938-0263 MEDICARE EXCLUSION OF SERVICES REIMBURSABLE UNDER AUTOMOTIBLE, NO-FAULT OR LIABILITY INSURANCE
0938-0262 REPORT ON PROVIDER PARTICIPATION IN THE MEDICAID PROGRAM
0938-0259 BILLING FORM FOR THE ALCOHOLISM SERVICES COVERAGE DEMONSTRATION
0938-0258 Physical Therapist in Independent Practice Request for Certification in the Medicare Program
0938-0257 SURVEY OF RECENT OPTOMETRY GRADUATES TO DETERMINE PRACTICE PATTERNS
0938-0256 EVALUATION STUDY OF THE HMO CAPITATION DEMDEMONSTRATION
0938-0255 EVALUATION OF MUNICIPAL HEALTH SERVICES PROGRAM
0938-0254 PRECLEARANCE OF PROPOSED CONTRACT TO PROVIDE DIRECT REIMBURSEMENT OF CLINICAL SOCIAL WORKERS
0938-0253 MEDICARE/MEDICAID HOSPITAL PROVIDERS OF LONG TERM CARE (SWING-BED PROVISION)
0938-0252 MEDICARE COMPETITION DEMONSTRATION PRECLEARANCE
0938-0251 MEDICARE - APPLICATION FOR HOSPITAL INSURANCE
0938-0249 SURVEY OF PRIVATE HEALTH INSURANCE
0938-0247 Medicaid Management Information System (MMIS)
0938-0246 MEDICAID QUALITY CONTROL REVIEW SCHEDULE (HCFA 301)
0938-0245 Request for Enrollment in Supplementary Medical Insurance and Supporting Regulations in 42 CFR 407.10 & 407.11
0938-0244 MEDIGAP STUDY
0938-0243 CONTRACTORS' INFORMATION COLLECTION-POST PROCESSING OF CLAIMS DATA
0938-0242 MEDICARE/MEDICAID FIRE SAFETY SURVEY REPORT
0938-0241 LONG-TERM CARE PROJECT OF NORTH SAN DIEGO COUNTY BILLING FORM
0938-0240 UNIFORM BILLING FORM FOR THE STATE OF NEW YORK, FR. UBF-1, "MEDICARE"
0938-0239 DELIVERY OF MEDICAL & SOCIAL SERVICES TO THE HOMEBOUND ELDERLY, NEW YORK CITY -- BILLING FORMS
0938-0238 CONTRACTORS INFORMATION COLLECTION - ORGAN PROCUREMENT AGENCY AND HISTOCOMPATIBILITY LABORATORY FORMS
0938-0236 Renal Dialysis Facility Cost Report
0938-0235 FREESTANDING FEDERALLY-FUNDED HEALTH CENTER COST REPORT
0938-0234 MEDICARE - CLAIMS DEVELOPMENT DATA PROVIDED BY CHIROPRACTORS
0938-0233 CONTRACTORS INFORMATION COLLECTIONS--CLAIMS DEVELOPMENT PHYSICIANS AND OTHER HEALTH CARE PROVIDERS
0938-0232 CONTRACTORS' INFORMATION COLLECTIONS - CARRIERS' EXTERNAL AUDIT OF SERVICES PROVIDED TO BENEFICIARIES
0938-0231 CONTRACTORS' INFORMATION COLLECTION-- "STATE MEDICAID AGENCY VERIFICATION OF SERVICES RECEIVED"
0938-0230 END STAGE RENAL DISEASE BILLING SUPPLEMENT FORM
0938-0229 CONTRACTORS INFORMATION COLLECTIONS - SOLE COMMUNITY PROVIDER EXEMPTION REQUESTS
0938-0228 CONTRACTORS INFORMATION COLLECTIONS - INTERMEDIARIES COLLECTION OF DATA ON OWNERS COMPENSATION
0938-0227 REQUEST FOR MEDICAL REVIEW OF PART B INTERMEDIARY OUTPATIENT THERAPY CLAIMS
0938-0226 CONTRACTORS INFORMATION COLLECTIONS - "CLAIMS DEVELOPMENT HOME HEALTH AGENCIES"
0938-0225 CONTRACTORS' INFORMATION COLLECTION - "MACHINE READABLE CLAIMS"
0938-0224 Medicare: Intermediary Request to Hospitals for Medical Information on Inpatient Claims for Statutorily Excluded Services -- SSA 1862; 42 CFR 411.15; 60 FR 181
0938-0223 Medicare Intermediary Request to Skilled Nursing Facilities for Medical Information on Claims to be Processed
0938-0222 MEDICARE-CLAIMS DEVELOPMT. DATA FROM BENEFIC. &/OR SUPPLIERS & PROVIDER, INTERMED. MAN. SEC. 3114,3647,3763,3766, CARRIER MAN. SEC. 2105,2125,3060,3300,3301, 10,000 & 12,000
0938-0220 PRECLEARANCE--EVALUATION OF THREE DEMONSTRATIONS IN NURSING HOMES CERTIFICATION SURVEY AND INSPECTIONS OF CARE
0938-0219 CONTRACTORS' INFORMATION COLLECTIONS - ADMINISTRATIVE DATA, UNCONNECTED WITH INDIVIDUAL CLAIM
0938-0218 CONTRACTORS' INFORMATION COLLECTIONS - RECONSIDERATIONS/ APPEALS
0938-0217 CONTRACTORS' INFORMATION COLLECTIONS INTERIM PAYMENT ADJUSTMENT FORMS FOR HHAS
0938-0216 CONTRACTOR INFORMATION COLLECTION - PROVIDER PERMANENT REFERENCE FILE
0938-0215 CONTRACTORS' INFORMATION COLLECTIONS--PERIODIC AUDIT OF PROVIDER/SUPPLIER CLAIMS DATA
0938-0214 QUESTIONS ON OTHER INSURANCE AVAILABLE TO MEDICARE BENEFICIARIES, MEDICARE SECONDARY PAYER
0938-0213 CONTRACTOR INFORMATION COLLECTION--CONTRACTOR PROGRAM INTEGRITY FORMS TO VERIFY SERVICES
0938-0212 CONTRACTORS' INFORMATION COLLECTION--AUDIT PROGRAMS
0938-0211 INSTALLMENT AGREEMENT ON BENEFICIARY REFUND OF OVERPAYMENT, HCFA-PUB.13-3, SECTION 3711.9, & HCFA-PUB.14.3, SECTION 7120.0, HCFA-R-9005
0938-0210 REGIONAL OFFICE MEDICAID QUALITY CONTROL FEDERAL REREVIEW PROCESS
0938-0209 MEDICARE - RURAL HEALTH CLINICS-REQUESTS FOR MEDICAL INFORMATION HCFA-PUB. 13-3 INTERMEDIARY MANUAL SEC. 3640.14
0938-0208 CONTRACTORS INFORMATION ON COLLECTIONS-REGIONAL OFFICE PROGRAM VALIDATION REVIEWS OF PROVIDERS AND MEDICAID AGENCIES
0938-0207 CONTRACTORS' INFORMATION COLLECTIONS -- COMPREHENSIVE HEALTH CENTER FORMS
0938-0206 REQUEST TO ADJUST CUSTOMARY CHARGE SCREEN
0938-0205 QUESTIONNAIRE CONCERNING FORGED CHECK
0938-0204 CONTRACTORS INFORMATION COLLECTIONS-HCFA REGIONAL OFFICE PROGRAM INTEGRITY FORMS TO VERIFY SERVICES
0938-0203 CONTRACTORS' INFORMATION COLLECTIONS - COLLATERAL CONTACTS
0938-0202 Home Office Cost Statement and Supporting Statement in Regulation in 42 CFR 413.17 and 413.20
0938-0201 CONTRACTORS' INFORMATION COLLECTIONS -- EXTENDED REPAYMENT SCHEDULE
0938-0200 CONTRACTORS' INFORMATION COLLECTION SUPPLEMENTAL DESK REVIEW
0938-0199 ANCILLARY SERVICES UTILIZATION STUDY
0938-0198 EVALUATION OF NEW YORK'S LONG-TERM HOME HEALTH CARE PROGRAM
0938-0197 QUESTIONNAIRE ON MEDICAID STATE AGENCY FRAUD AND ABUSE CONTROL ACTIVITIES
0938-0196 MEDICARE MENTAL HEALTH DEMONSTRATION COST & STATISTICAL REPORT
0938-0193 Transmittal and Notice of Approval of State Plan Material and Supporting Regulations in 42 CFR 430.10-430.20 and 440.167 (CMS-179)
0938-0190 TELEPHONE SURVEYS OF MEDICARE PART B PROVIDERS AND BENEFICIARIES (TO EVALUATE PART B FIXED PRICE CONTRACTS)
0938-0189 NATIONAL HEART TRANSPLANT STUDY
0938-0188 329 REQUIREMENT FOR NARRATIVE NOTATION OF HOME HEALTH VISIT IN MEDICAL RECORDS
0938-0186 DIRECT DEALING LETTER NO. 301-BILLING FOR PHYSICAL THERAPY SERVICES
0938-0185 MEDICARE URBAN CLINICS DEMONSTRATION PRE-CLEARANCE ORDS 81-4-095
0938-0184 PRECLEARANCE: MEDIGAP HCFA-81-ORDS-32/AMG
0938-0181 SURVEY FOR THE NATIONAL HOSPITAL RATE-SETTING STUDY
0938-0180 MEDICARE MEDICARE INTERIM PAYMENT UPDATE REPORT
0938-0179 PROVIDER-BASED PHYSICIAN QUESTIONNAIRE FOR DIRECT DEALING PROVIDER
0938-0178 DISCHARGE DATA REQUEST
0938-0177 HOSPICE STATEMENTS OF REIMBURSEMENTS
0938-0174 STUDY OF UNENTITLED ESRD POPULATION
0938-0173 MEDICAID QUALITY CONTROL DISPOSITION LIST
0938-0170 Blood Bank Inspection Checklist and Report and Supporting Regulations in 42 CFR 493.1269-493.1285
0938-0169 QUESTIONNAIRE ON REGULATORY REFORM
0938-0167 TRIAGE--COORDINATED CARE OF THE ELDERLY (BILLING FORMS)
0938-0165 Prepaid Health Plan Cost Report (CMS-276)
0938-0164 GROUP PRACTICE PREPAYMENT PLANS - SPECIAL ADMINISTRATIVE COST REPORT, QUARTERLY INVOICE OF AND FINAL SPECIAL ADMINISTRATIVE COSTS
0938-0163 MEDICARE REIMBRUSEMENT SETTLEMENT DATA FOR HOME HEALTH AGENCIES
0938-0162 EVALUATION OF REIMBURSING FOR HOME DIALYSIS SERVICES
0938-0161 HEALTH PREPAYMENT DATA CARD CODING SHEET
0938-0160 LETTER TO COLLCT DATA ON STATE REGULATION OF MEDIGAP INSURANCE POLICIES
0938-0159 MEDICARE REIMBURSEMENT SETTLEMENT DATA FOR HOSPITALS AND SKILLED NURSING FACILITIES
0938-0157 NATIONAL ASSESSMENT OF MEDICARE DIAGNOSTIC AND SURGICAL DATA QUALITY
0938-0156 PILOT TEST OF REVISED MEDICAID AND INTEGRATED QUALITY CONTROL FORMS
0938-0155 Requests for Medicare Payment by Municipal Health Services Program (MHSP) Clinics
0938-0153 PIP QUARTERLY REPORT FOR HOME HEALTH AGENCIES
0938-0152 NATIONAL SECOND SURGICAL OPINION PROGRAM - REACTION TO TELEVISION'S "20/20", UNNECESSARY SURGERY PROGRAM
0938-0151 LICENSURE FORMS FOR THE CLINICAL LABORATORY IMPROVEMENT ACT
0938-0150 BILLING FORMS FORM MEDICARE/MEDICAID HOSPICE DEMONSTRATION
0938-0149 EVALUATION OF THE SSOP MEDICARE DEMONSTRATIONS IN DETROIT AND NEW YORK AND THE MEDICAID PROGRAM IN MASSACHUSETTS
0938-0147 STATE MEDICAID QUALITY CONTROL SAMPLE SELECTION LISTS
0938-0146 STATE MQC SAMPLING PLANS
0938-0145 REQUEST FOR MEDICARE PAYMENT BY MMHD FACILITY
0938-0144 MEDICAID QUALITY CONTROL CORRECTIVE ACTION PLANS
0938-0143 FORM HCFA-231, "COMPENSATION SURVEY OF KEY ADMINISTRATIVE EMPLOYEES"
0938-0142 MEDICARE REIMBURSEMENT SETTLEMENT DATA FOR OUTPATIENT PHYSICAN THERAPY PROVIDERS
0938-0140 UNIFORM BILLING FORM
0938-0139 APPLICATION FOR FEDERAL ASSISTANCE FOR ESRD NETWORK COORDINATING COUNCIL
0938-0136 EVALUATION OF THE OKLAHOMA UTILIZATION REVIEW SYSTEM
0938-0134 SURVEY OF MEDICAID REIMBURSEMENT POLICIES
0938-0131 EVALUATION OF SECOND SURGICAL OPINION PROGRAMS FOR ELECTIVE SURGERY
0938-0119 PRESURGICAL SCREENING PROGRAM COST BENEFIT ANALYSIS QUESTIONNAIRE
0938-0117 UNIFORM BILL QUESTIONNAIRE
0938-0114 ESRDD DEMONSTRATION PROJECT COST REPORT
0938-0111 AMBULATORY HEALTH CARE CENTER STANDARDS FOR BUREAU OF COMMUNITY HEALTH SERVICES CENTERS
0938-0108 THIRD PARTY RESOURCE WORKSHEET MEDICAID
0938-0107 Rural Health Clinic Cost Report
0938-0106 HOME DIALYSIS TARGET RATE REIMBURSEMENT AGREEMENT AND INSTRUCTIONS
0938-0105 TUBERCULOSIS HOSPITAL REPORT FORM
0938-0104 PSYCHIATRIC HOSPITAL SURVEY REPORT FORM
0938-0103 PAPERWORK BURDEN ASSOCIATED WITH THE HOSPITAL SURVEY AND REQUEST TO ESTABLISH ELIGIBILITY
0938-0102 ORGAN PROCUREMENT/HISTOCOMPATIBILITY LABORATORY STATEMENT OF REIMBURSABLE COST
0938-0101 STATE AGENCY BUDGET FORECAST AND QUARTERLY GRANT REQUIREMENTS REPORT
0938-0100 MEDICARE/MEDICAID SNF SURVEY REPORT FORM
0938-0099 PENALTY REQUIREMENTS APPLICABLE TO THE EPSDT PROGRAM
0938-0097 CHILD HEALTH STATUS REPORT
0938-0094 MEDICAID: INTEGRATED QUALITY CONTROL REVIEW WORKSHEET
0938-0092 DEMONSTRATION PROJECT FOR CALCULATING ADJUSTED AVERAGE PER CAPITA COSTS FOR HMO'S
0938-0091 SURVEY OF MUNICIPAL HOSPITAL SERVICES
0938-0089 REQUEST FOR CLAIM NUMBER VERIFICATION-HCFA-1600
0938-0088 HOSPITAL INTERIM RATE CHANGE REPORT (PIP QUARTERLY REPORT)
0938-0087 PSRO GRANT APPLICATION AND INSTRUCTIONS
0938-0086 OWNERSHIP AND FINANCIAL INTEREST DISCLOSURE STATEMENT
0938-0085 PAPERWORK BURDEN ASSOCIATED WITH THE END-STAGE RENAL DISEASE FACILITY SURVEY
0938-0084 STERILIZATIONS AND HYSTERECTOMIES
0938-0083 REQUEST FOR ADDITIONAL MEDICAL INFORMATION
0938-0082 MEDICAID QUALITY CONTROL STATISTICAL SUMMARY REPORTS
0938-0081 INSTRUCTIONS FOR COMPLETION OF FEDERAL ASSISTANCE REPORTS--MEDICAID FRAUD
0938-0080 Application for Part A (Hospital Insurance) and Part B (Medical Insurance) for People with End-Stage Renal Disease and Supporting Statute and Regulations in 42 CFR 406.7 and 406.13 (CMS-43)
0938-0078 REQUEST FOR FEDERAL ASSISTANCE
0938-0077 SUMMARY FRAUD AND ABUSE REPORT FORMS
0938-0076 OFFICE OF PROGRAM INTEGRITY ABUSE REPORT (MEDICARE/MEDICAID)
0938-0075 RURAL HEALTH CLINIC BILLING
0938-0074 REQUEST TO ESTABLISH ELIGIBILITY IN THE MEDICARE/MEDICAID PROGRAM TO PROVIDE RURAL HEALTH CLINIC SERVICES
0938-0073 RURAL HEALTH CLINIC SURVEY REPORT
0938-0072 MEDICARE SECOND SURGICAL OPINION DEMONSTRATION PROJECTS
0938-0071 PHYSICAL THERAPIST IN INDEPENDENT PRACTICE--SURVEY REPORT
0938-0070 DELEGATED PROVIDER ADMISSIONS SUMMARY
0938-0069 QC MANUAL - QUALITY CONTROL IN MEDICAID
0938-0067 STATEMENT OF EXPENDITURES FOR MEDICAL ASSISTANCE PAYMENTS
0938-0066 PHYSICIAN EXTENDERS REIMBURSEMENT STUDY
0938-0065 REQUEST TO ESTABLISH ELIGIBILITY IN THE MEDICARE AND/OR MEDICAID PROGRAM TO PROVIDE OUTPATIENT PHYSICAL THERAPY AND/OR SPEECH PATHOLOGY SERVICES
0938-0064 ESRD TRANSPLANT INFORMATION--END-STAGE RENAL DISEASE MEDICAL INFORMATION SYSTEM
0938-0063 PROFESSIONAL STANDARDS REVIEW ORGANIZATION ROUTINE FEDERAL REPORTING REQUIREMENTS
0938-0062 MEDICAID: INTERMEDIATE CARE FACILITY FOR THE MENTALLY RETARDED OR PERSONS WITH RELATED CONDITIONS SURVEY REPORT FORM
0938-0061 Quarterly Showing
0938-0060 MONTHLY STATISTICAL REPORT ON MEDICAL CARE
0938-0059 STATISTICAL REPORT ON MEDICAL CARE: RECIPIENTS, PAYMENTS, SERVICES
0938-0057 INDIVIDUALIZED SERVICE PLAN (SHORT FORM, EXTENDED FORM 1 AND 2)
0938-0056 HOSPITAL, HOSPITAL-SKILLED NURSING FACILITY COMPLEX, COST REPORT
0938-0055 REQUEST FOR APPROVAL/ADVANCE APPROVAL AS A SUPPLIER OF ESRD SERVICES IN THE MEDICARE PROGRAM
0938-0054 HOSPITAL INSTITUTIONAL PLANNING QUESTIONNAIRE
0938-0053 SUMMARY OF DEFICIENCIES NOT CORRECTED
0938-0050 PROVIDER COST REPORTING FORMS FOR HOSPITALS AND HOSPITAL-SKILLED NURSING FACILITY COMPLEXES HAVING MORE THAN 99 BEDS
0938-0049 LABORATORY PERSONNEL QUALIFICATIONS APPRAISAL FOR DIRECTORS AND SUPERVISORS
0938-0048 RENAL DISEASE FACILITY COST AND STATISTICAL QUESTIONNAIRE
0938-0046 MEDICARE CHRONIC RENAL DISEASE MEDICAL EVIDENCE REPORT
0938-0045 Request for Reconsideration of Part A Medicare Claim and Supporting Regulations in 42 CFR, 405.711
0938-0044 POST-CERTIFICATION REVISIT REPORT AND CONTINUATION SHEET
0938-0043 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION AND CONTINUATION SHEET
0938-0042 REQUEST FOR MEDICARE PAYMENT--AMBULANCE
0938-0041 Third-Party Premium Billing Request and Supporting Regulations in 42 CFR 408.6
0938-0039 PROVIDER CHAIN OPERATOR DATA
0938-0038 GROUP PRATICE-PREPAYMENT PLAN STATEMENT OF REIMBURSEMENT COS T
0938-0037 OUTPATIENT REHABILITATION PROVIDER COST REPORT
0938-0036 REFERRAL AND TREATMENT PLAN
0938-0035 SSO Report of State Buy-in Problems, 42 CFR 407.40
0938-0034 REQUEST FOR HEARING-PART B MEDICARE CLAIM
0938-0033 Requesting for Review of Part B Medicare Claim and Supporting Regulation -- 42 CFR 405.807
0938-0032 PAPERWORK ASSOCIATED WITH THE DEPARTMENTAL CLINICAL LABORATORY SURVEY
0938-0031 DETERMINING LEVEL OF CARE REQUIRED BY PATIENT IN SKILLED NURSING FACILITY - PART I - REQUEST & PART II - NOTICE
0938-0027 The Request for Certification as a Supplier of Portable X-Ray and Portable X-Ray Survey Report form under the Medicare/Medicaid Program - Portable X-Ray Survey Report & Supporting Regulations..
0938-0025 Request for Termination of Premium-Hospital and/or Supplementary Medical Insurance and Supporting Regulations in 42 CFR 406.28 and 407.27
0938-0023 STATEMENT OF SUPPORT OF CLAIM FOR EMERGENCY HOSPITAL SERVICE
0938-0022 HOME HEALTH AGENCY STATEMENT OF REIMBURSABLE COST - HOSPITAL BASED HOME HEALTH AGENCY STATEMENT OF REIMBURSABLE COST
0938-0021 PREPAYMENT PLAN FOR GROUP MEDICAL PRACTICES DEALING THROUGH A CARRIER
0938-0020 REQUEST FOR INFORMATION - MEDICARE PAYMENTS FOR SERVICES TO A PATIENT NOW DECEASED
0938-0016 PROVIDER BILLING FOR PATIENT SERVICES BY PHYSICIANS
0938-0015 INPATIENT ADMISSION AND BILLING-CHRISTIAN SCIENCE SANATORIUM
0938-0013 PROVIDER BILLING FOR MEDICAL AND OTHER HEALTH SERVICES
0938-0012 HOME HEALTH AGENCY, AND COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY, BILLING
0938-0011 HOME HEALTH AGENCY SURVEY REPORT
0938-0010 INPATIENT HOSPITAL AND SKILLED NURSING FACILITY ADMISSION AND BILLING
0938-0008 REQUEST FOR PAYMENT
0938-0001 NATIONWIDE SURVEY OF INDEPENDENT PREPAID AND SELF-INSURED HEALTH PLANS