STATE MEDICAID QC SAMPLING PLANS

ICR 198302-0938-006

OMB: 0938-0146

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
112958 Migrated
ICR Details
0938-0146 198302-0938-006
Historical Active 198101-0938-005
HHS/CMS
STATE MEDICAID QC SAMPLING PLANS
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 04/04/1983
Retrieve Notice of Action (NOA) 02/07/1983
  Inventory as of this Action Requested Previously Approved
04/30/1985 04/30/1985
106 0 0
2,544 0 0
0 0 0

THE STATE MQC SAMPLING PLAN IS NECESSARY FOR HCFA TO MONITOR THE STATES' OPERATION OF THE MQC SYSTEM. THE SAMPLING PLAN INCLUDES ALL DATA INVOLVED IN THE STATE'S SAMPLE SELECTION PROCESS--POPULATION SIZE AND SAMPLE FRAME LISTS, SAMPLE SIZES, SAMPLE SELECTION PROCEDURES AND CLAIMS COLLECTION PROCEDURES.

None
None


No

1
IC Title Form No. Form Name
STATE MEDICAID QC SAMPLING PLANS HCFA-317

  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 106 0 0 0 106 0
Annual Time Burden (Hours) 2,544 0 0 0 2,544 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.
02/07/1983


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