Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
State Plan preprints to Implement Sections of the Deficit Reduction Act of 2006 and Third-party Disclosure for Non-emergencies New 4000 667 0 Other-6043 SMD
Form CMS-10190 6043 Cost Sharing Preprint
State Plan preprints to implement Sections of the Deficit Reduction Act of 2006 and Third-party Disclosure for Non-emergencies (CMS-10190) Modified 56 56 0
Total burden requested under this ICR: 4056 723 0  
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