Application and Re-application processes

Application and Triennial Re-application to Be a Qualified Entity to Receive Medicare Data for Performance Measurement (ACA Section 10332) (CMS-10394)

OMB: 0938-1144

IC ID: 198017

Documents and Forms

Document Name Document Type
Form CMS-10394 Application and Re-application processes Form and Instruction
6_Reapplicaiton Requiremetns List .pdf Instruction
6_Reapplicaiton Requiremetns List .pdf Instruction
QECPProgramGuide.pdf Instruction
QECPProgramGuide.pdf Instruction
CMS-10394 Application 6_PaperQECPReapplication.pdf Form and Instruction
CMS-10394 Application 6_PaperQECPReapplication.pdf Form and Instruction
CMS-10394 QECP Measure Production QA Worksheet 4_QE CP Phase 3 App List_Final.pdf Form and Instruction
CMS-10394 QECP Measure Production QA Worksheet 4_QE CP Phase 3 App List_Final.pdf Form and Instruction
CMS-10394 QECP Measure Information Workbook 5_QECP Phase 3 MIW List_Final.pdf Form and Instruction
CMS-10394 QECP Measure Information Workbook 5_QECP Phase 3 MIW List_Final.pdf Form and Instruction
CMS-10394 QECP Phase 1 Data Source Attestation Requirements 2_QECP Phase 1 DSA Requirements_Final.pdf Form and Instruction
CMS-10394 QECP Phase 1 Data Source Attestation Requirements 2_QECP Phase 1 DSA Requirements_Final.pdf Form and Instruction
CMS-10394 Qualified Entity Certification Program Data Security Rev 3_QECP Data Security Review 2020 FINAL v1.1_508.pdf Form and Instruction
CMS-10394 Qualified Entity Certification Program Data Security Rev 3_QECP Data Security Review 2020 FINAL v1.1_508.pdf Form and Instruction
CMS-10394 Letter of Commitment Template 5 QECP Letter of Commitment Template.pdf Form and Instruction
CMS-10394 Letter of Commitment Template 5 QECP Letter of Commitment Template.pdf Form and Instruction