View Information Collection Request (ICR) Package
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View Information Collection (IC) List
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View Generic ICR - OIRA Conclusion
OMB Control No:
0938-1148
ICR Reference No:
202607-0938-014
Status:
Active
Previous ICR Reference No:
202409-0938-028
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CMCS
Title:
[Medicaid] Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
08/05/2026
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/30/2026
Terms of Clearance:
By December 31, 2026, HHS/CMS must provide OMB with a written update describing the comments received on this ICR via the Community Engagement IFC (published June 1, 2026), any response to the comments provided, and if appropriate, which GenICs under this umbrella need to be revised as a result of those comments. As appropriate, HHS/CMS must revise any GenICs under this umbrella based on the public comments received. OMB will not approve any GenICs under this umbrella until it receives the written update, as appropriate depending on timing.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2029
36 Months From Approved
10/31/2027
Responses
25,274
0
19,623
Time Burden (Hours)
1,562,707
0
450,000
Cost Burden (Dollars)
0
0
0
Abstract:
The Center for Medicaid, CHIP, and Survey & Certification in CMS works in partnership with States to implement Medicaid and the Children's Health Insurance Program (CHIP), and the Social Security Act requires written plans between CMS and the State to implement these programs. The Affordable Care Act enacted comprehensive reform that requires modification of existing programs. In addition to the Medicaid and CHIP State plans, CMS also continues to work with States through other methods to further the goals of health reform, including program waivers and demonstrations and other technical assistance initiatives and reporting. This collection will provide streamlined submission forms for States to implement health reform initiatives in Medicaid and CHIP state plans, demonstrations, and waivers, including legislative requirements enacted by the Affordable Care Act.
Authorizing Statute(s):
Statute at Large:
21 Stat. 1115
Statute at Large:
19 Stat. 1901
Statute at Large:
19 Stat. 1915
Statute at Large:
21 Stat. 2101
Citations for New Statutory Requirements:
Statute at Large: 19 Stat. 1915
Statute at Large: 21 Stat. 2101
Statute at Large: 21 Stat. 1115
Statute at Large: 19 Stat. 1901
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AV98
Final or interim final rulemaking
91 FR 33348
06/03/2026
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
91 FR 33348
06/03/2026
30-day Notice:
Federal Register Citation:
Citation Date:
91 FR 33348
06/03/2026
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
6
IC Title
Form No.
Form Name
Active GenICs (NOA issued 07-29-2026)
See NOA
GenICs Active as of 7-29-2026
GenIC #100 New (Medicaid Community Engagement: Good Faith Effort Exemptions and Quarterly Reporting)
GenIC #101 New (Medicaid Community Engagement: Short-term Hardship Exception Requests)
GenIC #11 Revised (MAGI-Based Eligibility Verification Plan)
GenIC #11, GenIC #11, GenIC #11
MAGI-Based Eligibility Verification Plan Template
,
Disaster Relief MAGI-Based Verification Plan Addendum
,
MAGI Verification Plan Supplement: Community Engagement Guidance and Template
GenIC #35 Revised (Eligibility and Enrollment Performance Indicators)
GenIC #35
Eligibility and Enrollment Performance Indicators Template
GenIC #66 Revised (Eligibility Processing Data Report)
GenIC #66, GenIC #66, GenIC #66
Eligibility Processing Reports Portal Screen Shots
,
Data portal
,
Unwinding Eligibility and Enrollment Data Reporting Template
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
25,274
19,623
0
5,651
0
0
Annual Time Burden (Hours)
1,562,707
450,000
0
1,112,707
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Overall, the increase considers our currently approved burden ceiling, our active time estimates, time needed for CMS-2454-IFC, active time estimates that are no longer needed, our projected needs for 2026 – 2029, and the time needed for unanticipated GenICs.
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
07/30/2026
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