The Fiscal Soundness Reporting Requirements (CMS-906)

Fiscal Soundness Reporting Requirements (FSRR) (CMS-906)

Documents and Forms

Document Name Document Type
Form CMS-906 The Fiscal Soundness Reporting Requirements (CMS-906) Form and Instruction
CMS-906 CMS-906 Collection Instrument and Instructions Collection Instrument and Instructions_11-15-2024.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	The Fiscal Soundness Reporting Requirements (CMS-906)	Agency IC Tracking Number:	CM

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 516(a)(5) 42 CFR 460.208 42 CFR 423.514 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-906	CMS-906 Collection Instrument and Instructions	Collection Instrument and Instructions_11-15-2024.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,082	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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,305	347	1,958
Annual IC Time Burden (Hours)	769	116	653
Annual IC Cost Burden (Dollars)	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.