MEDICAID QUALITY CONTROL DISPOSITION LIST

ICR 198106-0938-003

OMB: 0938-0173

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
113028 Migrated
ICR Details
0938-0173 198106-0938-003
Historical Active
HHS/CMS
MEDICAID QUALITY CONTROL DISPOSITION LIST
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 08/05/1981
Retrieve Notice of Action (NOA) 06/11/1981
  Inventory as of this Action Requested Previously Approved
12/31/1982 12/31/1982
636 0 0
4,834 0 0
0 0 0

THE MQC DISPOSITION LIST IS MANAGEMENT TOOL USED TO MONITOR ELIGIBILITY REVIEWS, NEGATIVE CASE ACTION REPORT, AND PAYMENT REVIEWS. THIS REPORT AIDS IN STATE AND FEDERAL REVIEW COMPLETIONS. THE INFORMATION COLLECTED PROVIDES COMPLETION RATES AND STATUS REPORTS ON A MONTHLY BASIS.

None
None


No

1
IC Title Form No. Form Name
MEDICAID QUALITY CONTROL DISPOSITION LIST HCFA-321

  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 636 0 0 0 636 0
Annual Time Burden (Hours) 4,834 0 0 0 4,834 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.
06/11/1981


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