№ files_lp_4_process_3_091977
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Administrative questionnaire used by organizations requesting CMS data to attest to the implementation of security and privacy safeguards aligned with CMS Acceptable Risk Safeguards (ARS) 3.1 and NIST SP 800-53 control framework.
Program:
Data Privacy Safeguard Program
Document Type:
Self-Attestation Questionnaire
Subject:
Data Security and Privacy Controls for CMS Data
Organization / Authority:
Centers for Medicare & Medicaid Services (CMS)
Reference Standard:
CMS Acceptable Risk Safeguards (ARS) 3.1
Reference Framework:
NIST SP 800-53 Revision 4 Security and Privacy Controls
Purpose:
Attestation of organizational compliance with CMS security and privacy safeguard requirements
Primary Topic:
Information Security and Privacy Governance
Scope:
Access Controls, Security Controls, and Privacy Controls for CMS Data Environments
Applicable Environment Types:
Cloud Service Provider (CSP), Onsite, Hybrid Computing Environments
Responsible Role:
Data Custodian
Additional Contact Role:
Secondary Point of Contact (POC)
Related Document:
Data Management Plan (DMP)
Information Type Covered:
CMS data including PII/PHI
Intended Respondent:
Organizations requesting access to CMS data
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2015
Region / City:
N/A
Theme:
PCI PIN Security Requirements
Document Type:
Self-Assessment Questionnaire
Organization / Institution:
N/A
Author:
N/A
Target Audience:
Organizations performing a self-assessment for PCI PIN security compliance
Period of Validity:
N/A
Approval Date:
N/A
Date of Changes:
N/A
Context:
A self-assessment questionnaire for organizations to record their compliance with PCI PIN Security Requirements Version 2.0.
Note:
Year
Subject:
Psychology
Document Type:
Exam Tips
Target Audience:
Students preparing for SAQ exams
Note:
Year
Topic:
Data Privacy, Federal Agencies, Data Security
Document Type:
Questionnaire, Data Management Plan
Target Audience:
Federal Agencies
Purpose:
This form is for federal agencies requesting research data through the CMS Data Use Agreement (DUA) process.
Security Requirements:
Data Custodian responsible for compliance with CMS data security requirements.
Evidence Required:
Authority to Operate (ATO) Letter(s) with official details.
Year:
2025
Organization:
University of Michigan
Document type:
Guidance for Self-Assessment Questionnaire (SAQ) A
Audience:
Merchants hosting websites at U-M and accepting online credit card payments
Subject:
PCI compliance and online payment processing
Revision dates:
3/14/25, 2/16/22
Vendors:
Nelnet, Authorize.net, Paypal
Technical environment:
Interstitial Gateway, SSO portal, UM hosted websites
Year:
2022
Region / City:
United States / University of Michigan
Subject:
PCI Compliance
Document Type:
Guide
Organization:
University of Michigan
Author:
CampusGuard
Target Audience:
Merchants processing EPIC credit card payments using TrustCommerce
Effective Period:
Annual
Approval Date:
03/23/2022
Last Modified:
03/23/2022
PCI Compliance:
Yes
System Used:
TrustCommerce P2PE
Service Providers:
TrustCommerce
Security Training:
Yes
Incident Response Procedure:
Yes
Note:
Description
Organization:
Swiss National Science Foundation
Document type:
Data management plan template
Thematic area:
Research data management
Scope:
Research projects funded by SNSF
Content focus:
Data collection, documentation, ethics, legal issues, storage, preservation, sharing and reuse
Standards referenced:
FAIR Data Principles
Intended use:
Research project planning and documentation
Language:
English
Source type:
Institutional guideline template
Note:
Year
Topic:
Data Management
Document type:
Guideline
Institution:
FWF
Target audience:
Researchers, project managers
Note:
Year
Contextual description:
A template for a data management plan that must accompany a request for NIST funding, outlining requirements for data storage, sharing, and public access.
Issuing body:
National Center for Chronic Disease Prevention & Health Promotion
Form type:
Data Management Plan (DMP)
OMB Control Number:
0920-1301
Expiration Date:
10/31/2026
Applicable to:
NOFO or Contract applications and awards
Project phases:
New Application; New Award; Evaluation Plan; Continuation; Final
Estimated Public Reporting Burden:
60 minutes per response
Subject:
Management, access, documentation, and preservation of public health data
Geographic reference:
Atlanta, GA
Responsible agency contact:
CDC Reports Clearance Officer
Note:
Year
Year:
2018
Region / City:
Flanders
Topic:
Data Management Plan (DMP)
Document Type:
Template
Organization:
FWO (Research Foundation Flanders)
Author:
KU Leuven, Universiteit Antwerpen, Universiteit Gent, Universiteit Hasselt, Vrije Universiteit Brussel
Target Audience:
Researchers, Project Supervisors, Fellows
Period of validity:
Until the end of the project
Approval Date:
Not specified
Date of Changes:
Not specified
Note:
Year
Topic:
Data Privacy, Federal Agencies, Data Security
Document Type:
Questionnaire, Data Management Plan
Target Audience:
Federal Agencies
Purpose:
This form is for federal agencies requesting research data through the CMS Data Use Agreement (DUA) process.
Security Requirements:
Data Custodian responsible for compliance with CMS data security requirements.
Evidence Required:
Authority to Operate (ATO) Letter(s) with official details.
Document type:
Template form
Subject:
Deer management and woodland protection
Related programme:
Forestry Grant Scheme Sustainable Management of Forests (SMF)
Relevant options:
Reducing Deer Impact; Low Impact Silvicultural Systems (LISS); Native Woodland
Geographic context:
Scotland
Responsible authority referenced:
Scottish Forestry
Associated organisation:
NatureScot
Primary purpose:
Preparation of a Deer Management Plan for woodland areas
Planning period:
Five years
Key components:
Site overview; habitat assessment; collaborative deer management; management objectives; constraints; deer population assessment; density indicators; historical cull data
Target users:
Forest managers, landowners, forestry applicants
Required supporting materials:
Maps of management area, habitat locations, neighbouring land use and deer movement areas
Data fields included:
Woodland area, open ground area, deer species present, grid reference, population density estimates, habitat vulnerability to deer impact
Year:
2020
Region / City:
United States
Subject:
Eligibility Documentation for WIOA Title I-B Programs
Document Type:
Policy Change
Agency / Institution:
Department of Labor (DOL)
Author:
Not specified
Target Audience:
Case Managers, LWDBs, Service Providers
Effective Date:
March 23, 2020
Expiration Date:
June 30, 2024
Date of Approval:
Not specified
Date of Amendments:
December 3, 2021
Effective Date:
March 23, 2020
Expiration Date:
June 30, 2024
Note:
Minimum Requirements for Documenting Eligibility for WIOA Title I-B Programs
Period of Effectiveness:
March 23, 2020 – June 30, 2024
Year:
2023
Region / City:
United States
Theme:
Employment, Workforce Development
Document Type:
Eligibility Form
Agency / Organization:
WIOA
Author:
WIOA Career Planner
Target Audience:
Individuals applying for the Dislocated Worker Program
Validity Period:
Ongoing
Approval Date:
N/A
Date of Changes:
N/A
Context:
A form used by individuals to self-attest their eligibility for the Dislocated Worker Program under WIOA based on specific categories of dislocation, including layoffs, military service, and other factors.
Year:
N/A
Region / City:
N/A
Subject:
Employment / Healthcare / Social Work
Document Type:
Self-attestation form
Organization:
N/A
Author:
N/A
Target Audience:
Healthcare professionals, social workers, and other regulated professionals
Validity Period:
N/A
Approval Date:
N/A
Amendment Date:
N/A
Document Type:
Self-attestation form
Subject:
Fit and Proper Person Test declaration
Jurisdiction:
England
Applicable Legislation:
Fit and Proper Person Test requirements
Related Checks:
DBS check
Relevant Sectors:
Healthcare and social care
Declarations Included:
Character, qualifications, professional registration status, health capability, criminal convictions, bankruptcy status, barred list status, misconduct and mismanagement
Obligation to Notify:
Duty to inform the chair of any change in circumstances affecting compliance
Signatories:
Applicant and Chair of the organisation
Fields Included:
Name, job title/role, professional registrations, DBS check date, appraisal date, signatures and dates
Intended Audience:
New starters applying for a role within a regulated organisation
Note:
Year
Topic:
Data Privacy, Federal Agencies, Data Security
Document Type:
Questionnaire, Data Management Plan
Target Audience:
Federal Agencies
Purpose:
This form is for federal agencies requesting research data through the CMS Data Use Agreement (DUA) process.
Security Requirements:
Data Custodian responsible for compliance with CMS data security requirements.
Evidence Required:
Authority to Operate (ATO) Letter(s) with official details.