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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
QHP Certification
Modified
975
182325
0
Form
CMS-10433
Data Template Administrative
Form
CMS-10433
Medical Essential Community Providers
Form
CMS-10433
Dental Essential Community Provider
Form
CMS-10433
URAC Application
Form
CMS-10433
NCQA Template
Form
CMS-10433
AAAHC
Form
CMS-10433
Network Adequacy
Form
CMS-10433
Program Attestations
Form
CMS-10433
Accreditation Attestations
Form
CMS-10433
Plan and Benefit
Form
CMS-10433
Prescription Drugs Template
Form
CMS-10433
Service Area
Form
CMS-10433
Network ID
Form
CMS-10433
Rates Table
Form
CMS-10433
Business Rules
Instruction
Reinsurance
Modified
23800
119000
0
Instruction
Reinsurance and Risk Adjustment
Modified
2400
15800
0
Instruction
States
Unchanged
50
150
0
Total burden requested under this ICR:
27225
317275
0
To view an IC, click on IC Title