Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Dual Eligible Special Needs Plan Contract with the State Medicaid Agency New 633 20968 0 Form and Instruction CMS-10796 D-SNP State Medicaid Agency Contract Matrix
Form and Instruction CMS-10796 Special Needs Plan (SNP) Contract Status Review Matrix
Total burden requested under this ICR: 633 20968 0  
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