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

View Information Collection (IC)

Bundle: #7 (Cycle IV and Cycle V), #37 (Managed Care Rate Setting), #50 (Community First Choice State Plan), and #52 (Delivery System and Provider Payment Initiatives Under Medicaid Managed Care Prod
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction No   Printable Only
Instruction No   Paper Only
Other-37 - Crosswalk No   Paper Only
Form CMS-10398 (#50) Yes Yes Fillable Fileable
Form CMS-10398 (#52) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#7) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#7) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#7) Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#7) Yes Yes Fillable Fileable
Other-7 - Crosswalk No   Printable Only

Health Health Care Services

 

144 0
   
State, Local, and Tribal Governments
 
   70 %

  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 497 0 497 0 0 0
Annual IC Time Burden (Hours) 3,192 0 3,192 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
37 - Supporting Statement 01/27/2017
50 - Supporting Statement 01/27/2017
52 - Supporting Statement 01/27/2017
7 - Crosswalk 01/27/2017
Bundled Burden Summary Table 01/27/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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