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

View Information Collection (IC)

GenIC #26 (Extension) - Medicaid Adult and Child Core Set Measures
 
New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-PRA Disclosure Statement No   Printable Only
Form and Instruction 390-CQM 2018-CCW-CH-PRA-D Yes Yes Fillable Fileable
Form and Instruction 385-CQM 2018-ADD-CH-PRA-D Yes Yes Fillable Fileable
Form and Instruction 385-CQM 2018-ADD-CH-PRA-D Yes Yes Fillable Fileable
Form and Instruction 429-AQM 2018 ABA-AD PRA-D Yes Yes Fillable Fileable
Form and Instruction 245-QSSI-MACPro-PRA-AdditionalNotes-D Yes Yes Fillable Fileable

Health Health Care Services

 

56 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested 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 224 0 224 0 0 0
Annual IC Time Burden (Hours) 8,960 0 8,960 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GenIC Supporting Statement 08/30/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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