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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility
Modified
34
34000
0
Form
CMS-10184
CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Instruction
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility
Modified
408
40800
0
Form
CMS-10184
CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Instruction
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility
Modified
34
341870
0
Instruction
Form
CMS-10184
CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility
Modified
408
40800
0
Instruction
Form
CMS-10184
CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility
Modified
408
40800
0
Instruction
Form and Instruction
CMS-10184
CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility
Modified
34
34000
0
Instruction
Form
CMS-10184
CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility
Modified
34
3400
0
Instruction
Form
CMS-10184
CMS-10184.FINAL-PERM Eligibility Error Rate Forms
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (MEQC Substitution)
Modified
19
407094
0
Form and Instruction
CMS-10184D
Detailed Payment Review Findings
Form and Instruction
CMS-10184A
Cases Selected for Review: Monthly Sample Selection List
Form and Instruction
CMS-10184B
Detailed Active Case Review Findings
Form and Instruction
CMS-10184E
Summary Findings
Reinstatement of Prior Burden Estimates for CMS-10184E
New
204
20400
0
Form
CMS-10184.FINAL-PERM_Eligibility_Error_Rate_Forms
CMS-10184.FINAL-PERM_Eligibility_Error_Rate_Forms
Instruction
Total burden requested under this ICR:
1583
963164
0
To view an IC, click on IC Title