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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
GenIC #55 (New): Limit on Federal Financial Participation for Durable Medical Equipment in Medicaid
Agency IC Tracking Number:
CMCS
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
CMS-10398 #55
State Fee Schedule Drop
State Fee Schedule Drop-3-21-18.xlsx
Yes
Yes
Fillable Fileable
Instruction
Instructions for the State Fee Schedule Drop spreadsheet-3-20-18.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
56
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
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)
448
0
448
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Crosswalk
Crosswalk-DMEchanges-3-27-18.xlsx
04/18/2018
Instructions (Track Changes)
Instructions for the State Fee Schedule Drop spreadsheet-TRACK CHANGES.docx
04/18/2018
Public Comment: 1k2-917g-qdjy
1k2-917g-qdjy - Comment.pdf
04/18/2018
Public Comment: 1k2-9138-nado
1k2-9138-nado - Comment.pdf
04/18/2018
Public Comment: 1k2-9176-k8w4
1k2-9176-k8w4 - Combined Cover and Comment.pdf
04/18/2018
Public Comment: 1k2-9159-fleh
k2-9159-fleh - Combined Cover and Comment.pdf
04/18/2018
Supporting Statement
GenIC #55 - Supporting Statement rev 04-18-2018 by OSORA PRA-CLEAN.docx
04/18/2018
Response to 60-day Comments
Letter to summarize the 60 day comments on DME limit on FFP collection of information.docx
04/18/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.