Evaluation of the CMS Network of Quality Improvement and Innovation Contractors Program (NQIIC) (CMS-10769)

ICR 202401-0938-008

OMB: 0938-1424

Federal Form Document

Forms and Documents

Document Name	Status
Form CMS-10769 Outpatient Clinician Survey Form and Instruction	New
Form CMS-10769 HQIC Hospital Survey Form and Instruction	Modified
Form CMS-10769 NQIIC Nursing Home Survey Form and Instruction	Modified
CMS-10769 response to comments 1-11-24.docx Supplementary Document	2024-01-25
CMS-10769_Supporting_Statement_B_3-2-2023.docx Supporting Statement B	2024-01-25
CMS-10769_Supporting_Statement_A__1-10-24.docx Supporting Statement A	2024-01-26

IC Document Collections

IC ID	Document Title	Status
264722	Outpatient Clinician Survey Form and Instruction	New
248181	HQIC Hospital Survey Form and Instruction	Modified
248179	NQIIC Nursing Home Survey Form and Instruction	Modified