PRA Listing
PRAs that are available for comment and have not been released by the Department.
CMS Form Number | Date | Subject |
---|---|---|
CMS-10217 | 04/20/2007 | Physician Survey for the 2006 Medicare Oncology Demonstration Program |
CMS-R-39 | 05/30/2007 | Medicare and Medicaid Programs: Conditions of Participation for Home Health Agencies and Supporting Regulations in 42 CFR 484.10, 484.12, 484.14, 484.16, 484.18, 484.36, 484.48, and 484.52 |
CMS-10407 | 08/17/2011 | Summary of Benefits and Coverage Uniform Glossary |
CMS-417 | 09/03/2010 | Hospice Medicare Certification |
CMS-10227 | 09/03/2010 | PACE State Plan Amendment Pre-print |
CMS-R-0053 | 08/20/2010 | Imposition of Cost Sharing Charges Under Medicaid and Supporting Regulations Contained in 42 CFR Section 447.53 |
CMS-10244 | 09/10/2010 | Medicaid State Program Integrity Assessment (SPIA) |
CMS-10206 | 08/04/2006 | Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Accreditation Proposals from Independent Accrediting Bodies |
CMS-10246 | 08/24/2007 | COST AND RESOURCE UTILIZATION (CRU) DATA COLLECTION FOR THE MEDICARE POST ACUTE CARE PAYMENT REFORM DEMONSTRATION |
CMS-10195 | 06/09/2006 | Evaluation of the Medicare Recovery Audit Contractor Demonstration RAC Provider Satisfaction Survey |
CMS-10116 | 04/27/2007 | Medicare Program; Conditions for Payment of Power Mobility Devices, including Power Wheelchairs and Power-Operated Vehicles (CMS-3017-IFC) |
CMS-10148 | 01/08/2007 | HIPAA Administrative Simplification Non-Privacy Enforcement |
CMS-10088 | 09/01/2006 | Notification of FIs and CMS of co-located Medicare providers and Supporting Regulations in 42 CFR 22 and 412.533 |
CMS-10140 | 04/04/2005 | Claims Error Rate Testing (CERT) / Electronic Records Exploratory Survey |
CMS-10207 | 09/10/2010 | Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records |
CMS-10168 | 09/13/2006 | Medicare Program: Complex Medical Review |
CMS-10225 | 05/08/2007 | Disclosures to Patients by Certain Hospitals & Critical Access Hospitals |
CMS-10184 | 05/26/2006 | Payment Error Rate Measurement of Eligibility in Medicaid and the State Children';s Health Insurance Program (SCHIP) |
CMS-10201 | 08/16/2006 | Evaluation of the Home Health Independence Demonstration: Survey of Home Health Agencies |
CMS-255 | 02/23/2007 | Municipal Health Services Cost Report Form and supporting Regulations 42CFR 405.2470 |
CMS-10247 | 08/24/2007 | Sponsor application for CMS coverage under the Medicare Clinical Trial/Research Policy |
CMS-10243 | 07/27/2007 | Data Collection for Administering the Medicare Continuity Assessment Record and Evaluation (CARE)Instrument |
CMS-10238 | 07/27/2007 | Testing of Revised OASIS Instrument for Home Health Quality Measures and Data Analysis |
CMS-588 | 04/28/2006 | Electronic Funds Transfer Authorization Agreement |
CMS-10233 | 05/23/2007 | Regional Preferred Provider Organization (RPPO) Reconciliation Cost Report |
CMS-460 | 03/15/2007 | Medicare Participating Physician or Supplier Agreement |
CMS-R-137 | 08/19/2005 | Internal Revenue Service/Social Security Administration/Centers for Medicare and Medicaid Services Data Match and Supporting Regulations in 42 CFR Sections 411.20-411.206 |
CMS-R-50 | 04/14/2008 | Medical Records Review Under the Prospective Payment System (PPS) and Supporting Regulations in 42 CFR 412.40- 412.52 |
CMS-R-305 | 2012-05-31 | External Quality Review Protocols |
CMS-10279 | 03/20/2009 | Ambulatory Surgical Center Conditions for Coverage |
CMS-10314 | 08/20/2010 | Medicare Savings Program Protection from Medicaid Estate Recovery - State Plan Preprint Under Title 19 |
CMS-10260 | 03/11/2011 | Medicare Advantage and Prescription Drug Program: Final Marketing Provisions CFR 422.111(a)(3) and 423.128 (a)(3) |
CMS-10115 | 03/11/2011 | FEDERAL REIMBURSEMENT OF EMERGENCY HEALTH SERVICES FURNISHED TO UNDOCUMENTED ALIENS (SECTION 1011) PROVIDER ENROLLMENT APPLICATION |
CMS-10343 | 09/10/2010 | State Plan Preprint for Medicaid Recovery Audit Contractors (RACs) |
CMS-R-5 | 03/20/2009 | Physician Certification/Recertification in Skilled Nursing Facilities (SNFs) Manual Instructions |
CMS-10133 | 03/20/2009 | Competitive Acquisition Program for Medicare Part B Drugs: Vendor Application and Bid Form |
CMS-10009 | 10/03/2008 | HIPAA Nondiscrimination Provisions and Supporting Regulations in 45 CFR 146.121 (f)(2)(v)(A) |
CMS-10001 | 10/03/2008 | Health Insurance Portability and Accountability Act (HIPAA) Nondiscrimination Provisions and Supporting Regulations in 45 CFR 146.121(h) and 121(i)(2)(i) |
CMS-10295 | 09/09/2009 | Recovery Act: Reporting Requirements for States Under FMAP Increase and TMA Provisions |
CMS-10320 | 2012-08-14 | Health Care Reform Insurance Web Portal Requirements |
CMS-10316 | 09/17/2010 | Medicare Prescription Drug Plan (PDP) and Medicare Advantage Prescription Drug Plan (MA-PD) Disenrollment Reasons Survey |
CMS-10305 | 07/24/2012 | Medicare Part C and Part D Data Validation (42 CFR 422.516g and 423.514g) |
CMS-R-206 | 04/10/2009 | Information Collection Requirements Referenced in HIPAA title I for the Group Market |
CMS-R-205 | 04/10/2009 | Information Collection Requirements Referenced in HIPAA title I for the Individual Market |
CMS-10136 | 03/06/2012 | Physician Group Practice Transition Demonstration (PGP-TD)Performance Assessment Tool ("PAT") |
CMS-R-211 | 03/09/2011 | Template for Child Health Plan Under Title XXI of the Social Security Act Children's Health Insurance Program |
CMS-10220 | 12/10/2010 | Provider Enrollment Chain and Ownership System (PECOS) Web Security Consent Form |
CMS-10390 | 2012-08-13 | Hospice Quality Reporting Program |
CMS-367 | 10/01/2010 | Medicaid Drug Rebate Program |
CMS-10239 | 11/15/2007 | Conditions of Participation for Critical Access Hospitals and Supporting Regulations in 42 CFR 485.65, 485.23, 485.618, 485.631, 485.635, 485.641, 485.643 |
CMS-10221 | 06/26/2007 | Worksheet for Recording Results of Medicare Site Visits of Independent Diagnostic Testing Facilities (IDTFs) |
CMS-R-247 | 06/23/2006 | 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, and and 414.63 |
CMS-10230 | 11/16/2007 | PACE Audit Guide Version 1 |
CMS-R-48 | 11/15/2007 | Conditions of Participation for Hospitals and Supporting Regulations in 482.12, 482.13, 482.21, 482.22, 482.23, 482.24, 482.27, 482.30, 482.41, 482.43, 482.45, 482.53, 482.56, 482.57, 482.60, 482.61, 482.62, and 485.616 and 485.631 |
CMS-10328 | 03/25/2011 | Medicare Self-Referral Disclosure Protocol |
CMS-10409 | 09/02/2011 | Long Term Care Hospital (LCTH) Quality Reporting Program-Pressure Ulcer Measure Data Set |
CMS-10114 | 09/14/2011 | NPI Application and Update Form |
CMS-10367 | 03/11/2011 | Medicaid State Plan Preprint for Use by States When Implementing Section 6505 of the [Patient Protection and] Affordable Care Act |
CMS-R-185 | 03/01/2011 | Granting and Withdrawal of Deeming Authority to Private Nonprofit Accreditation Organizations and of State Exemption Under State Laboratory Programs and Supporting Regulations |
CMS-10296 | 08/28/2009 | Electronic Health Record (EHR)Testing |
CMS-10147 | 09/16/2011 | Standardized Pharmacy Notice: Your Prescription Cannot be Filled (f/k/a Medicare Prescription Drug Coverage and Your Rights) |
CMS-10362 | 03/25/2011 | Autism Spectrum Disorders (ASD): State of the States Services and Supports for People with ASD |
CMS-10286 | 10/07/2009 | Notice of Research Exception under the Genetic Information Nondiscrimination Act |
CMS-10313 | 04/06/2010 | New Quality Measures for Medicare Advantage Organizations |
CMS-1880 and CMS-1882 | 2012-03-13 | Certification as a Supplier of Portable X-Ray and Portable X-Ray Survey Report Form and Supporting Regulations at 42 CFR Part 486.100-486.110 |
CMS-10298 | 10/09/2009 | Data Collection For Developing Outpatient Therapy Payment Alternatives (DOTPA) |
CMS-18F5 | 10/08/2010 | Application For Hospital Insurance |
CMS-10141 | 04/06/2010 | Medicare Prescription Drug Benefit Plan |
CMS-10036 | 10/24/2008 | Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) data and Supporting Regulations in 42 CFR 412 Subpart P |
CMS-10300 | 10/09/2009 | Additional State Plan Option for Providing Premium Assistance State Plan Templates Under Title XIX and XXI |
CMS-10287 | 10/09/2009 | Medicare Quality of Care Complaint Form |
CMS-416 | 04/16/2010 | Annual Early and Periodic Screening, Diagnostic and Treatment Report |
CMS-10179 | 01/11/2007 | Information Collection Requirements for Requests by Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital Prospective Payment System (LTCH PPS) for an Alternative Cost-to-Charge Ratio and Supporting Regulations in 42 CFR 412.84(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) |
CMS-10158 | 05/31/2005 | Beneficiary Survey on the Medicare Home Health Independence Demonstration |
CMS-R-71 | 01/19/2005 | Quality Improvement Organizations (QIO) Assumption of Responsibilities and Supporting Regulations in 42 C.F.R. Sections 412.44, 412.46, 431.630, 476.71, 476.73, 476.74, and 476.78 |
CMS-10319 | 10/29/2010 | Pre-Existing Condition Insurance Plan-Program Solicitation and Contractor's Proposal Package |
CMS-2540-10 | 03/11/2011 | Skilled Nursing Facility and Skilled Nursing Facility Health Care Complex Cost Report |
CMS-10361 | 04/01/2011 | Request for Adjustments to MLR Standard for a States Individual Market |
CMS-R-107 | 11/14/2008 | Medicaid-Determining Third Party Liability (TPL) State Plan Preprint |
CMS-10170 | 11/28/2008 | Retiree Drug Subsidy (RDS) Payment Request and Instructions |
CMS-10270 | 06/27/2008 | Evaluation of the Home Health Pay for Performance Demonstration: Survey instrument |
CMS-R-267 | 05/16/2008 | Medicare Advantage Program: Application and Contract Requirements Referenced in 42 CFR Part 422 |
CMS-10299 | 10/02/2009 | State Plan Amendment Template for Option to Cover Certain Children and Pregnant Women Lawfully Residing in U.S. |
CMS-10095 | 04/30/2010 | Detailed Explanation of Non-Coverage (42 CFR 422.626(e)(1)), and Notice of Medicare Non-Coverage (42 CFR 422.624(b)(1)) |
CMS-381 | 04/01/2011 | Identification of Extension Units of Medicare Approved Outpatient Physical Therapy/Outpatient Speech Pathology (OPT/OSP) Providers and Supporting Regulations in 42 CFR 485.701-485.729 |
CMS-10102 | 2012-04-27 | National Implementation of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) |
CMS-10110 | 12/12/2008 | Manufacturer Submission of Average Sales Price (ASP) data for Medicare Part B Drugs and Biologicals |
CMS-R-296 | 05/15/2009 | Home Health Advance Beneficiary Notice (HHABN) |
CMS-1763 | 05/15/2009 | REQUEST FOR TERMINATION OF PREMIUM HOSPITAL AND/OR SUPPLEMENTARY MEDICAL INSURANCE |
CMS-R-194 | 05/15/2009 | Medicare Disproportionate Share Adjustment Procedures and Criteria and Supporting Regulations in 42 CFR 412.106 |
CMS-43 | 05/15/2009 | APPLICATION FOR HOSPITAL INSURANCE BENEFITS FOR INDIVIDUALS WITH END STAGE RENAL DISEASE |
CMS-R-297 | 04/19/2010 | Request for Employment Information |
CMS-R-0282 | 11/06/2009 | Medicare Advantage Appeals and Grievance Data Disclosure Requirements (42 CFR section 422.111) |
CMS-10191 | 10/28/2009 | Medicare Parts C and D Universal Audit Guide |
CMS-10197 | 04/02/2010 | Evaluation of the Medicare National Competitive Bidding Program for DME |
CMS-10123 and 10124 | 04/01/2011 | Notice of Provider Non-Coverage (CMS-10123) and Detailed Explanation of Non-Coverage (CMS-10124) |
CMS-R-263 | 2012-04-27 | Site Investigation for Durable Medical Equipment (DME) Suppliers |
CMS-10241 | 2012-03-02 | Survey of Retail Prices: Payment and Utilization Rates, and Performance Rankings |
CMS-R-26 | 10/08/2010 | Clinical Laboratory Improvement Amendments (CLIA) and Supporting Regulations in 42 CFR 493.1-.2001 |
CMS-R-153 | 10/15/2010 | Medicaid Drug Utilization Review (DUR) Annual Report |
CMS-10358 | 10/22/2010 | Medicaid Program; MMIS APD Template for Use by States When Implementing the Mandatory National Correct Coding Initiative in Medicaid, SMD Letter #10-017 dated September 1, 2010 |
CMS-2088-92 | 10/22/2010 | Outpatient Rehabilitation Provider Cost Report utilized by Community Mental Health Centers |
CMS-10165 | 04/30/2010 | Electronic Health Records Demonstration System (EHRDS) - practice application and profile update system |
CMS-10003 | 2012-07-06 | Notice of Denial of Medical Coverage (or Payment) |
CMS-10054 | 10/22/2010 | Recognition of payment for new technology services for New Technology ambulatory payment classification (APC) groups under the Outpatient Prospective Payment System |
CMS-2552-10 | 04/30/2010 | Hospital and Health Care Complexes Cost Report and supporting Regulations in 42 CFR section 413.20 and section 413.24 |
CMS-10078 | 05/29/2009 | Matching Grants to States for the Operation of High Risk Pools |
CMS-10261 | 2012-07-06 | Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516 (a) |
CMS-855O | 2012-04-27 | Medicare Registration Application |
CMS-10185 | 2012-07-18 | Medicare Part D Reporting Requirements and Supporting Regulations |
CMS-1856 and CMS-1893 | 04/08/2011 | Request for Certification in the Medicare and/or Medicaid Program to Provide Outpatient Physical Therapy and/or Speech Pathology Services and Outpatient Physical Therapy-Speech Pathology Survey Report |
CMS-10379 | 10/07/2011 | Rate Increase Disclosure and Review Reporting Requirements (45 CFR Part 154) |
CMS-265-11 | 10/07/2011 | Independent Renal Dialysis Facility Cost Report And Supporting Regulations in 42 CFR Sections 413.20, 413.24, 413.174 |
CMS-10382 | 04/08/2011 | Medicaid Emergency Psychiatric Demonstration |
CMS-10388 | 04/29/2011 | Section 1115 Demonstration HIV and AIDS Application Template |
CMS-10340 | 10/07/2011 | Collection of Encounter Data from Medicare Advantage Organizations |
CMS-10237 | 2012-07-06 | Part C Medicare Advantage and 1876 Cost Plan Expansion Application (CY 2013) |
CMS-10137 | 2012-07-06 | Application for New and Expanding Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug (MA-PD), including Cost Plans and Employer Group Waiver Plans |
CMS-10384 | 03/25/2011 | Health Insurance Assistance Database |
CMS-10265 | 08/01/2008 | Mandatory Insurer Reporting Requirements of Section 111 of the Medicare, Medicaid and SCHIP Act of 2007 (MMSEA) (P.L.110-173) |
CMS-10273 | 06/05/2009 | Evaluation of the Medicare Care Management Performance Demonstration and the Electronic Health Records Demonstration |
CMS-R-10 | 08/15/2008 | BPD-718: Advance Directives (Medicare and Medicaid) |
CMS-10311 | 11/17/2010 | Medicare program/Home Health Prospective Payment System Rate Update for CY 2010: Physician Narrative Requirement and Supporting Regulation in 42 CFR 424.22, CY 2011 Final Physician Face-to-Face Encounter in 42 CFR 424.22 (a)(1)(v), and changes to therapy coverage requirements at 42 CFR 409.44(c): (Associated Regulation: CMS-1510-F; RIN 0938-AP88) |
CMS-10344 | 11/22/2010 | Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services |
CMS-10346 | 11/22/2010 | Appeals of Quality Bonus Payment Determinations |
CMS-10349 | 11/22/2010 | The Medicare Advantage and Prescription Drug Program: Customized Enrollee Data CFR 422.111(b)(11) and 423.128(b)(12) |
CMS-10053 | 11/13/2009 | Paid Feeding Assistants in Long Term Care Facilities and Supporting Regulations at CFR 42 Section 483.160 |
CMS-10171 | 05/14/2010 | Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers (CMS-10171) |
CMS-10224 | 04/29/2011 | Healthcare Common Procedure Coding System (HCPCS) Level II Code Modification Request Process |
CMS-10209 | 11/04/2011 | Medicare Advantage Chronic Care Improvement Program and Quality Improvement Project Reporting Tools |
CMS-10291 | 10/21/2011 | State Collection and Reporting of Dental Provider and Benefit Package Information on the Insure Kids Now! Web site and Hotline |
CMS-10347 | 11/22/2010 | Agent Broker Training Requirements |
CMS-10348 | 11/22/2010 | Changes to Close the Part D Coverage Gap, Improvements to MTM Programs, Independence of LTC Consultant Pharmacists |
CMS-10350 | 11/22/2010 | De Minimis for LIS Individuals and Uniform Exceptions and Appeals Process for Prescription Drug Plans and MA-PD Plans |
CMS-10352 | 11/22/2010 | Notification of Involuntary Disenrollment by the Centers for Medicare & Medicaid Services for Failure to Pay the Part D Income Related Monthly Adjustment Amount |
CMS-R-131 | 09/10/2010 | Advance Beneficiary Notice of Noncoverage (ABN) |
CMS-P-0015A | 05/28/2010 | Medicare Current Beneficiary Survey |
CMS-10408 | 10/10/2011 | Early Retiree Reinsurance Program: Survey of Plan Sponsors |
CMS-10240 | 05/28/2010 | Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration |
CMS-1728-94 | 05/28/2010 | Home Health Agency Cost Report |
CMS-265-94 | 05/28/2010 | Independent Renal Dialysis Facility Cost Report |
CMS-10317 | 06/18/2010 | The Medicare Acute Care Episode (ACE) Demonstration |
CMS-10069 | 06/18/2010 | Medicare Waiver Demonstration Application |
CMS-855S | 2012-04-04 | Medicare Enrollment Application— Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers |
CMS-10333 | 2012-07-27 | Consumer Assistance Program Grants |
CMS-10396 | 05/31/2011 | Medicare Part D Medication Therapy Management Program - Standardized Format |
CMS-855 (A, B, I, R) | 2012-04-04 | Medicare Enrollment Applications |
CMS-10366 | 11/18/2011 | Nursing Home Quality Improvement Questionnaire |
CMS-10203 | 2012-08-10 | Medicare Health Outcomes Survey (HOS) |
CMS-10308 | 06/04/2010 | Parts C and D Complaints Resolution Performance Measures |
CMS-10416 | 2012-05-16 | State Exchange Certification Application |
CMS-10288 | 06/12/2009 | State Plan Preprint to Implement Required Dental Benefits Pursuant of CHIPRA 2009 |
CMS-10062 | 01/09/2009 | Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments |
CMS-10373 | 06/17/2011 | Medical Loss Ratio - Quarterly Reporting for Mini-med Plans and Expatriate Plans |
CMS-10097 | 07/02/2009 | The Medicare Contractor Provider Satisfaction Survey (MCPSS) |
CMS-10098 | 12/10/2010 | Beneficiary Satisfcation Survey |
CMS-10219 | 06/18/2010 | Healthcare Effectiveness Data and Information Set (HEDIS) Data Collection for Medicare Advantage |
CMS-10289 | 06/12/2009 | CHIPRA 2009 Dental Benefits: Implementation of Optional Dental-only Supplemental Coverage |
CMS-10394 | 06/08/2011 | Application To Be a Qualified Entity to Receive Medicare Data for Performance Measurement |
CMS-10417 | 2012-04-27 | Medicare Fee-for-Service Prepayment Medical Review |
CMS-10393 | 06/10/2011 | Medicare Beneficiary and Family-Centered Satisfaction Survey |
CMS-10249 | 10/21/2011 | Administrative Requirements for Section 6071 of the Deficit Reduction Act |
CMS-10356 | 11/19/2010 | Evaluation of Practice Models for Dual Eligibles and Medicare Beneficiaries with Serious Chronic Conditions |
CMS-R-235 | 05/20/2011 | Data Use Agreement Information Collection Requirements, model language, and supporting regulations in 45 CFR Section 5b |
CMS-10252 | 05/20/2011 | Data Use Agreement (DUA) Certificate of Disposition for Data Acquired from the Centers for Medicare & Medicaid Services (CMS) |
CMS-10380 | 05/16/2011 | Rate Review Grants to States and Territories Cycle I and II Funding Opportunity Announcement Application and Reporting |
CMS-209 | 11/29/2011 | Laboratory Personnel Report (CLIA) and Supporting Regulations in 42 CFR 493.1357, 493.1363, 493.1405, 493.1406, 493.1411, 493.1417, 493.1423, 493.1443, 493.1449, 493.1455, 493.1461, 493.1462, 493.1469, 493.1483, 493.1489 and 493.1491 |
CMS-29 | 11/29/2011 | Request for Certification as a Rural Health Clinic Form and Supporting Regulations in 42 CFR 491.1-491.11 |
CMS-R-246 | 05/31/2011 | Medicare Advantage and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS) |
CMS-10418 | 04/02/2012 | Annual MLR and Rebate Calculation Report |
CMS-10292 | 05/18/2011 | State Medicaid HIT Plan, Planning Advance Planning Document and Update, Implementation Advance Planning Document and Update and Annual IAPD for implementation of Section 4201 of the American Recovery and Reinvestment Act of 2009 |
CMS-10321 | 06/28/2011 | Early Retiree Reinsurance Program |
CMS-R-240 | 07/09/2010 | Prospective Payments for Hospital Outpatient Service and Supporting Regulations is 42 CFR 413.65 |
CMS-10335 | 07/12/2010 | Current State Practices Related to Payments to Providers for Health Care-Acquired Conditions |
CMS-906 | 2012-09-04 | The Fiscal Soundness Reporting Requirements |
CMS-10079 | 01/15/2010 | Hospital Wage Index Occupational Mix Survey and Supporting Regulations in 42 CFR, Section 412.64 |
CMS-64 | 12/10/2010 | Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program |
CMS-21B | 12/10/2010 | State Children's Health Insurance Program Budget Report for the Title XXI Program State Plan Expenditures |
CMS-37 | 12/10/2010 | Medicaid Program Budget Report |
CMS-10342 | 06/17/2011 | Process for Obtaining Waivers of the Annual Limits Requirements of PHS Act Section 2711 |
CMS-10398 | 0012-05-03 | State plan Home and Community-Based Services Administration and Operation |
CMS-10368 | 12/23/2011 | Dental Action Plan Template for Medicaid and CHIP Programs |
CMS-179 | 12/16/2011 | Medicaid State Plan Base Plan Pages |
CMS-1561 | 07/23/2010 | Health Insurance Benefit Agreement |
CMS-R-244 | 07/30/2010 | MEDICARE AND MEDICAID: PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE; Final) CONTAINED IN 42 CFR 460.12-460.210 |
CMS-10152 | 2012-08-10 | Data Collection for Medicare Beneficiaries Receiving NaF-18 Positron Emissions Tomography (PET) to Identify Bone Metastasis in Cancer |
CMS-R-257 | 08/15/2008 | Medicare Advantage & Part D Disenrollment Requests Collected Through 1-800-MEDICARE |
CMS-10190 | 08/14/2009 | State Plan Preprints to Implement Section 6043 of the Deficit Reduction Act of 2006 and Third-party Disclosure for Non-Emergencies |
CMS-R-284 | 2012-08-15 | Medicaid Statistical Information System (MSIS) |
CMS-10307 | 01/29/2010 | Medical Necessity Disclosure under MHPAEA and Claims Denial Disclosure under MHPAEA |
CMS-R-148 | 01/21/2011 | Limitations on Provider Related Donations and Health Care Related Taxes; Limitation on Payments for Disproportionate Share Hospitals and Supporting Regulations in 42 CFR 433.68, 433.74, and 447.272 |
CMS-R-266 | 01/21/2011 | Medicaid Disproportionate Share Hospital Annual Reporting |
CMS-216 | 01/21/2011 | Organ Procurement Organization/Histocompatibility Laboratory Statement of Reimbursable Costs, Manual Instructions and Supporting Regulations contained in 42 CFR 413.20 and 413.24 |
CMS-10402 | 07/15/2011 | Medicaid State Plan Preprint for Use by States When Implementing Section 6401, Provider Screening and Other Enrollment Requirements Under Medicare, Medicaid and CHIP |
CMS-10385 | 07/15/2011 | Expedited Checklist: Medicaid Eligibility & Enrollment Systems-Advance Planning Document (E&E-APD) |
CMS-1880 and CMS-1882 | 12/23/2011 | Certification as a Supplier of Portable X-Ray and Portable X-Ray Survey Report Form and Supporting Regulations at 42 CFR Part 486.100-486.110 |
CMS-10275 | 07/23/2010 | CAHPS Home Health Care Survey: (Associated Regulation: CMS-1510-P; RIN 0938-AP88) |
CMS-10146 | 07/23/2010 | Notice of Denial of Medicare Prescription Drug Coverage |
CMS-R-249 | 07/23/2010 | Hospice Cost and Data Report and supporting regulations 42 CFR 413.20 and 42 CFR 413.24 |
CMS-287-05 | 01/28/2011 | Chain Home Office Cost Statement and supporting regulations in 42 CFR sections 413.17 and 413.20 |
CMS-R-308 | 07/23/2010 | Children's Health Insurance Program |
CMS-R-268 | 01/14/2011 | CMS Survey Tool for http://www.cms.gov and http://www.medicare.gov |
CMS-10142 | 01/04/2012 | CY 2011 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) |
CMS-10066 | 01/25/2010 | Detailed Notice of Discharge (DND) |
CMS-21 | 12/10/2010 | Quarterly Children's Health Insurance Program (CHIP) Statement of Expenditures for the Title XXI Program |
CMS-10374 | 07/15/2011 | Survey and Certification Training Staff Training Needs Assessment, Evaluation/Survey - Question Compilation |
CMS-9042 | 07/15/2011 | Accelerated Payments and Supporting Regulations 42 CFR, Section 412.116(f), 412.632(e), 413.64(g), 413.350(d), and 484.245 |
CMS-10236 | 12/12/2008 | Disclosure of Financial Relationships Report (DFRR) |
CMS-R-306 | 01/13/2012 | Use of Restraint and Seclusion in Psychiatric Residential Treatment Facilities (PRTFs) for Individuals Under Age 21 |
CMS-10412 | 01/04/2012 | Section 1115 Demonstration: Long Term Services and Supports and Other Service Models for Individuals with Disabilities and Chronic Conditions |
CMS-R-262 | 01/04/2012 | CY 2013 Plan Benefit Package (PBP) Software and Formulary Submission |
CMS-10112 | 01/28/2011 | Phone Surveys of Products and Services for Medicare Payment Validation and Supporting Regulations in 42 CFR 405.502 |
CMS-R-21 | 02/11/2011 | Withholding Medicare Payments to Recover Medicaid Overpayments and Supporting Regulations in 42 CFR 447.31 |
CMS-437 | 02/11/2011 | State Survey Agency Work Sheets for Verifying Exclusions from the Prospective Payment System and Supporting Regulations in 42 CFR Parts 412.25 - 412.27 |
CMS-1771 | 02/10/2011 | Attending Physicians Statement and Documentation of Medicare Emergency and Supporting Regulations in 42 CFR Section 424.103 |
CMS-724 | 08/20/2010 | Medicare/Medicaid Psychiatric Hospital Survey Data |
CMS-R-74 | 01/04/2012 | Income and Eligibility Verification System |
CMS-222 | 02/11/2011 | Independent Rural Health Center/Freestanding Federally Qualified Health Center Cost Report and Supporting Regulations 42 CFR 413.20 AND 42 CFR 413.24 |
CMS-10008 | 02/11/2011 | Process and Information Required to Determine Eligibility of Drugs, Biologicals, and Radiopharmaceutical Agents for Transitional Pass-Through Status Under the Hospital Outpatient Prospective Payment System (OPPS) |
CMS-116 | 08/20/2010 | Clinical Laboratory Improvement Amendments Application for Certification |
CMS-R-216 | 08/20/2010 | Issuance of Advisory Opinions Concerning Physicians Referrals |
CMS-10198 | 08/21/2009 | Creditable Coverage Disclosure to CMS Online Form and Instructions |
CMS-10151 | 09/05/2008 | Data Collection for Medicare Beneficiaries Receiving Implantable Cardioverter-defibrillators for Primary Prevention of Sudden Cardiac Death |
CMS-10421 | 0002-05-29 | Fee-for-Service Recovery Audit Prepayment Review Demonstration and Prior Authorization Demonstration |
CMS-10215 | 08/20/2010 | Medicaid Payment for Prescription Drugs - Physicians and Hospital Outpatient Departments Collecting and Submitting Drug Identifying Information to State Medicaid Programs |
CMS-10052 | 08/20/2008 | 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 |
CMS-10360 | 02/11/2011 | Consumer Research on Public Reporting of Hospital Outpatient Measures (CMS-10360) |
CMS-10106 | 02/18/2011 | Medicare Authorization to Disclose Personal Health Information (CMS-10106) |
CMS-10351 | 09/03/2010 | ESRD PPS Transition Election and Attestations of Low-Volume |
CMS-668B | 02/07/2012 | Post Clinical Laboratory Survey Questionnaire and Supporting Regulations in 42 CFR 493.1771, 493.1773, and 493.1777 |
CMS-1557 | 02/07/2012 | Survey Report Form for Clinical Laboratory Improvement Amendments (CLIA) and Supporting Regulations in 42 CFR 493.1-493.2001 |
CMS-10161 | 02/02/2012 | New Freedom Initiative - Web-based Reporting System for Grantees |
CMS-372(S) | 2012-04-04 | Annual Report on Home and Community Based Services Waivers and Supporting Regulations in 42 CFR 440.180 and 441.300-310 |
CMS-10392 | 07/28/2011 | Consumer Operated and Oriented Plan [CO-OP] Program |
CMS-10424 | 2012-05-16 | Cooperative Agreement to Support Establishment of the Affordable Care Act's Health Insurance Exchanges |
CMS-855I | 2012-01-30 | Medicare Enrollment Application for Physician and Non-Physician Practitioners |
CMS-855R | 2012-06-15 | Reassignment of Medicare Benefits |
CMS-10406 | 03/06/2010 | Probable Fraud Measurement Pilot |
CMS–437A and CMS–437B | 04/04/2012 | State Agency Sheets for Verifying Exclusions from the Inpatient Prospective Payment System and Supporting Regulations in 42 CFR Parts 412.20–412.29 |
CMS-10427 | 2012-06-07 | For-Profit PACE Study |
CMS–10429 | 2012-06-27 | Surveys of Physicians and Home Health Agencies to Assess Access Issues for Specific Medicare Beneficiaries as Defined in Section 3131(d) of the ACA |
CMS-10423 | 2012-04-17 | Health Plan Identifier, Other Entity Identifier, and Change to National Provider Identifier Requirements |
CMS-10169 | 2012-07-27 | Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program |
CMS-10425 | 2012-05-11 | Evaluation of Patient Satisfaction and Experience of Care for Medicare Beneficiaries with End-Stage Renal Disease (ERSD): Impact of the ESRD Prospective Payment System (PPS) and ESRD Quality Incentive Program (QIP) |
CMS–643 | 2012-07-18 | Hospice Survey and Deficiencies Report Form and Supporting Regulations |
CMS–10422 | 2012-05-11 | 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-10210 | 2012-05-11 | Hospital Reporting Initiative – Hospital Quality Measures |
CMS-10432 | 2012-05-11 | Inpatient Psychiatric Facility Quality Reporting Program |
CMS-10431 | 2012-05-11 | PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) Program |
CMS-10436 | 2012-06-01 | Evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration |
CMS-10435 | 2012-06-01 | Essential Health Benefits Benchmark Plans and Accrediting Entities Data Collection |
CMS-10434 | 2012-06-08 | Medicaid and CHIP Program (MACPro) |
CMS–10389 | 2012-07-24 | The Home and Community-Based Service (HCBS) Experience Survey |
CMS-10433 | 2012-07-02 | Initial Plan Data Collection to Support Qualified Health Plan (QHP) Certification and Other Financial Management and Exchange Operations |
CMS-10438 | 2012-07-02 | Data Collection to Support Eligibility Determinations and Enrollment for Employees in the Small Business Health Options Program |
CMS-10439 | 2012-07-02 | Data Collection to Support Eligibility Determinations and Enrollment for Small Businesses in the Small Business Health Options Program |
CMS-10440 | 2012-07-02 | Data Collection to Support Eligibility Determinations for Insurance Affordability Programs and Enrollment through Affordable Insurance Exchanges, Medicaid and Children’s Health Insurance Program Agencies |
CMS-10428 | 2012-07-06 | PCIP Authorization to Share Personal Health Information |
CMS-359 and CMS-360 | 2012-08-31 | Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms |
CMS-10028 | 2012-06-15 | State Health Insurance Assistance Program (SHIP) Client Contact Form, Public and Media Activity Report Form, and Resource Report Form |
CMS-2567 | 2012-07-18 | Deficiencies and Plan of Correction (CMS–2567) and Supporting Regulations contained in 42 CFR 488.18, 488.26, and 488.28 |
CMS–10447 | 2012-07-30 | Durable Medical Equipment Face-to-Face Requirements (RIN 0938–AR11; CMS-1590-P) |
CMS-10444 | 2012-08-10 | Minimum Data Set for Medicaid Incentives for Prevention of Chronic Diseases (MIPCD) demonstration program |
CMS–10276 | 2012-07-30 | Physician Quality Reporting System (RIN 0938–AR11; CMS-1590-P) |
CMS-R-218 | 2012-07-06 | ICRs contained in 45 CFR Part 162; HIPAA Standards for Electronic Transactions |
CMS-10381 | 2012-08-10 | ICD-10 Industry Readiness Assessment |
CMS-10149 | 08/31/2012 | Health Insurance Reform: Electronic Security Standards |
CMS-10441 | 2012-07-06 | Medicare Plan Finder Experiment |
CMS-10445 | 2012-09-14 | Medicare Advantage Quality Bonus Payment Demonstration |
CMS-838 | 2012-09-17 | Medicare Credit Balance Reporting Requirements and Supporting Regulations in 42 CFR 405.371, 405.378 and 413.20 |
CMS–10143 | 2012-09-17 | Monthly State File of Medicaid/Medicare Dual Eligible Enrollees |
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