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View Information Collection (IC)

View Information Collection (IC)

[Medicaid] GenIC #64 (Revision) Medicaid Section 1115 Substance Use Disorder (SUD) Demonstrations: Federal Meta Analysis CMCS
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1a Yes Yes Fillable Fileable
Form 1b Yes Yes Fillable Fileable
Form and Instruction 1c No   Printable Only
Form 1d Yes Yes Fillable Fileable
Form 1e Yes Yes Fillable Fileable
Form 1f Yes Yes Fillable Fileable
Form 1g Yes Yes Fillable Fileable
Form 3a Yes Yes Fillable Fileable
Form 3b Yes Yes Fillable Fileable
Form 3c Yes Yes Fillable Fileable
Form 3d Yes Yes Fillable Fileable
Form 3e Yes Yes Fillable Fileable
Form 3f Yes Yes Fillable Fileable
Form and Instruction 3g Yes Yes Fillable Fileable
Form and Instruction 3h Yes Yes Fillable Fileable
Form and Instruction 3i Yes Yes Fillable Fileable
Form 3j Yes Yes Fillable Fileable
Form 4a Yes Yes Fillable Fileable
Form 4b Yes Yes Fillable Fileable
Form 4c Yes Yes Fillable Fileable
Form 4d Yes Yes Fillable Fileable
Form 4e Yes Yes Fillable Fileable
Form and Instruction 4f Yes Yes Fillable Fileable
Form 4g Yes Yes Fillable Fileable

Health Health Care Services

 

211 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 384 0 384 0 0 0
Annual IC Time Burden (Hours) 506 0 506 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Supporting Statement 03/02/2026
Public Comment (Anonymous) 03/02/2026
Response to Public Comments 03/02/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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