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Evaluation Of Section 2176 Home And Community Based Care Medicaid Waiver Program
EVALUATION OF SECTION 2176 HOME AND COMMUNITY BASED CARE MEDICAID WAIVER PROGRAM
OMB: 0938-0349
IC ID: 113489
OMB.report
HHS/CMS
OMB 0938-0349
ICR 198404-0938-003
IC 113489
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0349 can be found here:
1985-10-02 - Reinstatement with change of a previously approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
EVALUATION OF SECTION 2176 HOME AND COMMUNITY BASED CARE MEDICAID WAIVER PROGRAM
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
HCFA-431
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
71
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
71
0
71
0
0
0
Annual IC Time Burden (Hours)
2,982
0
2,982
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.