Information Collection

Medicaid Quality Control Review Schedule (hcfa 301)

IC 113234 under ICR 198201-0938-003 · OMB 0938-0246.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0246 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

MEDICAID QUALITY CONTROL REVIEW SCHEDULE (HCFA 301)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-301				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 155,438

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	155,438	155,438
Annual IC Time Burden (Hours)	969,600	969,600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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

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