Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Communications and Review Support Unchanged 36 23400 0
Corrective Action Report Unchanged 36 9000 0
Monthly Sampling Lists Removed 0 0 0 Form CMS-10184 Monthly Sample Selection List
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (MEQC Substitution) Removed 0 0 0 Form and Instruction CMS-10184 MEQC Substitution
Form CMS-10184 MEQC substitution Detailed Case Review Findings
Pre-cycle Report Unchanged 36 3600 0
Reinstatement of Prior Burden Estimates for CMS-10184E Removed 0 0 0 Form and Instruction CMS-10184 MEQC substitution Summary of Findings
Reporting Individual Payment Findings Removed 0 0 0 Form CMS-10184 Detailed Payment Review Findings
Reporting Individual Review Findings Removed 0 0 0 Form CMS-10184 Detailed Active Case Review Findings
Form CMS-10184 Review Findings
Summary of Eligibility and Payment Review Findings Removed 0 0 0 Form and Instruction CMS-10184 Monthly Sample Selection List
Total burden requested under this ICR: 108 36000 0  
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