Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
GenIC #7 (Revision): Connecting Kids to Coverage Outreach and Enrollment
Agency IC Tracking Number:
CMCS
IC Status:
Unchanged
Obligation to Respond:
Voluntary
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 #7
Semi-Annual Report Template
ATTACHMENT 1-Semi-Annual Report Template508.pdf
Yes
Yes
Fillable Fileable
Form
CMS-10398 #7
Final Report Template
ATTACHMENT 2-Final Report Template508.pdf
Yes
Yes
Fillable Fileable
Form
CMS-10398 #7
HK2019 and HK2020 Monthly Progress Report Template
ATTACHMENT 3-HK2019 and HK2020 Monthly Progress Report Template508.pdf
Yes
Yes
Fillable Fileable
Form
CMS-10398 #7
HK2019 Monthly Progress Report with Targets Template
ATTACHMENT 4-Monthly Progress Report with Targets.pdf
Yes
Yes
Fillable Fileable
Form
CMS-10398 #7
HK2022 and HK2023 Monthly Progress Report Template
ATTACHMENT 5-HK2022 and HK2023 Monthly Progress Report Template.pdf
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:
91
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
1,365
0
0
0
0
1,365
Annual IC Time Burden (Hours)
7,826
0
0
0
0
7,826
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Generic Supporting Statement
GenIC_7-Generic SupportingStatement_(2022 version 14).docx
12/13/2022
Track Change - HK2022 and HK2023 Monthly Progress Report Template
Track Change - Attachment 5 - HK2022 and HK2023 Monthly Progress Report Template.pdf
12/13/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.