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ICRs Regarding Requirements for Public Disclosure of In-network Rates (One-time)
Transparency in Pricing Information (CMS-10715)
OMB: 0938-1429
IC ID: 249967
OMB.report
HHS/CMS
OMB 0938-1429
ICR 202601-0938-002
IC 249967
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ICRs Regarding Requirements for Public Disclosure of In-network Rates (One-time)
Agency IC Tracking Number:
CCIIO - 10715
Is this a Common Form?
Yes
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
45 CFR 147.210(c)(1)(ii)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-In-network Rate Machine-Readable File Data Elements
CMS-10715 (Appendix 2) In-network Rate File 508.pdf
Yes
Yes
Paper Only
Other-The Allowed Amount Machine-Readable File Data Elements
CMS-10715 (Appendix 3) Allowed Amount File 508.pdf
Yes
Yes
Paper Only
Other-Prescription Drug Machine-Readable File Data Elements
CMS-10715 (Appendix 4) Prescription Drug File 508.pdf
Yes
Yes
Paper Only
Other-The Change-Log Machine-Readable File Data Elements
CMS-10715 (Appendix 5) Change Log File 508.pdf
Yes
Yes
Paper Only
Other-The Utilization Machine-Readable File Data Elements
CMS-10715 (Appendix 6) Utilization File 508.pdf
Yes
Yes
Paper Only
Other-The Taxonomy Machine-Readable File Data Elements
CMS-10715 (Appendix 7) Taxonomy File 508.pdf
Yes
Yes
Paper Only
Other-The Text Machine-Readable File Data Elements
CMS-10715 (Appendix 8) Text File 508.pdf
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
790
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
790
0
0
-7,373
0
8,163
Annual IC Time Burden (Hours)
486,640
0
0
-1,130,188
0
1,616,828
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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