Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
1135 Waiver Request Automated Process Modified 6699 6699 0 Form and Instruction CMS-10752 Waiver Inquiry Form
Acute Hospital Care at Home Modified 496 1625 0 Form and Instruction CMS-10752 Acute Hospital at Home
Form and Instruction CMS-10752 AHCAH Data Measures form
Form and Instruction CMS-10752 AHCAH waiver
Total burden requested under this ICR: 7195 8324 0  
To view an IC, click on IC Title