QC MANUAL - QUALITY CONTROL IN MEDICAID

ICR 197504-0938-002

OMB: 0938-0069

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
112773 Migrated
ICR Details
0938-0069 197504-0938-002
Historical Active
HHS/CMS
QC MANUAL - QUALITY CONTROL IN MEDICAID
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 04/11/1975
Retrieve Notice of Action (NOA) 04/11/1975
  Inventory as of this Action Requested Previously Approved
03/31/1978 03/31/1978
36,000 0 0
504,000 0 0
0 0 0



None
None


No

1
IC Title Form No. Form Name
QC MANUAL - QUALITY CONTROL IN MEDICAID QCM 301-4, QCM 401.1, QCM-401.4

  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 36,000 0 0 0 36,000 0
Annual Time Burden (Hours) 504,000 0 0 0 504,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/11/1975


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