View Information Collection (IC)

View Information Collection (IC)

#24: Medicaid Accountability – Upper Payment Limits
 
New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction I - ICFID instructions final.doc No   Printable Only
Instruction II - ICFID Guidance final.docx No   Printable Only
Instruction III - Clinic Instructions Final.doc No   Printable Only
Instruction IV - Clinic UPL Guidance final.docx No   Printable Only
Instruction V - ACR Narrative Instructions Final Draft Clean.docx No   Printable Only
Instruction VI - 4 4 Phys Review Guidance Web Version Final Draft Clean.docx No   Fillable Printable
Instruction VII - Other facility Instructions final.docx No   Printable Only
Instruction VIII - Other Facility Guidance -Final.docx No   Fillable Printable
Instruction IX - Funding Questions.doc No   Printable Only

Health Health Care Services

 

56 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 56 0 56 0 0 0
Annual IC Time Burden (Hours) 2,240 0 2,240 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
#24 Supporting Statement: Medicaid Accountability – Upper Payment Limits #24 Medicaid Accountability UPL Part 2 Supporting Statement [Dec 2014].docx 12/22/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.