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Medicare Mental Health Demonstration Cost & Statistical Report

IC 113076 under ICR 198110-0938-002 · OMB 0938-0196.

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MEDICARE MENTAL HEALTH DEMONSTRATION COST & STATISTICAL REPORT
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 266A No No
Form 266Q No No
Form HCFA-266, No No


    

45 0
   
Private Sector Businesses or other for-profits
 
   0 %

  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 405 0 405 0 0 0
Annual IC Time Burden (Hours) 3,330 0 3,330 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.