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Form CMS-R-0235L Data Use Agreement - Limited Data Sets
What Is Form CMS-R-0235L?
This is a legal form that was released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services on June 1, 2020 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form CMS-R-0235L?
A: Form CMS-R-0235L is a Data Use Agreement (DUA) for accessing Limited Data Sets (LDS) from the Centers for Medicare & Medicaid Services (CMS).
Q: What is a Limited Data Set (LDS)?
A: A Limited Data Set (LDS) is health information that has been stripped of direct identifiers, such as names and addresses, but still contains some patient information.
Q: Who can use Form CMS-R-0235L?
A: Form CMS-R-0235L can be used by researchers, organizations, and entities that need access to Limited Data Sets (LDS) for research or public health purposes.
Q: What are the requirements for using Form CMS-R-0235L?
A: To use Form CMS-R-0235L, the requester must enter into a Data Use Agreement (DUA) with CMS, adhere to strict privacy and security safeguards, and use the data for approved purposes only.
Q: What is the purpose of Form CMS-R-0235L?
A: The purpose of Form CMS-R-0235L is to facilitate the use of Limited Data Sets (LDS) while ensuring the privacy and security of patient information.
Q: What is the duration of Form CMS-R-0235L?
A: The duration of Form CMS-R-0235L is typically one year, but it may be extended upon request and approval.
Q: What happens if the terms of Form CMS-R-0235L are violated?
A: If the terms of Form CMS-R-0235L are violated, CMS may terminate the agreement and take legal action against the requester.
Q: Can Form CMS-R-0235L be used for commercial purposes?
A: No, Form CMS-R-0235L cannot be used for commercial purposes. It is intended for research and public health purposes only.
Q: What are the key provisions of Form CMS-R-0235L?
A: The key provisions of Form CMS-R-0235L include confidentiality requirements, data safeguarding measures, permitted uses of the data, and reporting obligations.
Form Details:
- Released on June 1, 2020;
- The latest available edition released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services;
- Easy to use and ready to print;
- Yours to fill out and keep for your records;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form CMS-R-0235L by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services.
Download Form CMS-R-0235L Data Use Agreement - Limited Data Sets
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