View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Bundle: (GenIC 1) Medicaid Buy In, (GenIC 2) CNIPRA Cycle II, and (GenIC 3) PIE Transaction
 
New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10398-007 Yes Yes Fillable Printable
Form and Instruction CMS-10398-006 Yes Yes Fillable Printable
Instruction Yes No Fillable Printable
Instruction Yes No Fillable Printable
Form and Instruction CMS-10398-008 Yes Yes Fillable Printable

Health Health Care Services

 

130 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 169 0 0 0 0 0
Annual IC Time Burden (Hours) 3,380 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Medicaid Buy-In - Supporting Statement 04/11/2012
CHIPRA Cycle II Semi-Annual Report Template - Supporting Statement 04/11/2012
PIE Transaction - Supporting Statement 04/11/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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