Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2023 Renewal: Extension without change of active collections of information (GenICs #1, #2, #3, #15, #22, #26, #45, #47, and #77) New 696 20712 0 Other-Active GenICs Forms and Supplemental Documents
GenIC #22 (Revision): Health Home State Plan Amendment (SPA) New 18 54 0 Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Form CMS-10434 #22
Other-1945 Implementation Guide
Other-1945A Implementation Guide
GenIC #77 (Revision): Medicaid Extended Postpartum Coverage and Continuous Eligibility for Children New 75 5 0 Form CMS-10434 #77
Form CMS-10434 #77
Form CMS-10434 #77
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 789 20771 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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