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Home & Community Based Waiver Requests and Supporting Regulations; 42 CFR 440.180, 441.300-.310
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 440.180 42 CFR 441.300-310

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-8003 Yes Yes Fillable Fileable
Instruction No   Printable Only

Health Health Care Services

 

34 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 64 0 -7 0 0 71
Annual IC Time Burden (Hours) 5,332 0 -673 0 0 6,005
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk: Application 03/19/2024
Crosswalk: Technical Guide 03/19/2024
Track Changes: Application 03/20/2024
Track Change: Technical Guide 03/20/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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