Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Active GenICs (NOA issued 07-29-2026) New 14559 231896 0 Form and Instruction See NOA
GenIC #100 New (Medicaid Community Engagement: Good Faith Effort Exemptions and Quarterly Reporting) New 18 380 0
GenIC #101 New (Medicaid Community Engagement: Short-term Hardship Exception Requests) New 105300192 1208364 0
GenIC #11 Revised (MAGI-Based Eligibility Verification Plan) New 156 5520 0 Form and Instruction GenIC #11
Form and Instruction GenIC #11
Form and Instruction GenIC #11
GenIC #35 Revised (Eligibility and Enrollment Performance Indicators) New 2324 11352 0 Other-Performance Indicators Data Dictionary
Form and Instruction GenIC #35
GenIC #66 Revised (Eligibility Processing Data Report) New 2388 8872 0 Form and Instruction GenIC #66
Other-Eligibility Processing Data Report Specifications
Other-Data Report Instrument Metrics
Other-SHO# 24-002
Form and Instruction GenIC #66
Form and Instruction GenIC #66
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 105319637 1466384 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 1692 96252 0  
To view an IC, click on IC Title