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Information Collection

Information Collection Requirements In 42 Cfr Part 434, Subparts A Thru E, Medicaid Contracts With Health Maintenance Organizations (hmos) & Prepaid Health Plans

IC 113431 under ICR 198601-0938-002 · OMB 0938-0326.

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INFORMATION COLLECTION REQUIREMENTS IN 42 CFR PART 434, SUBPARTS A THRU E, MEDICAID CONTRACTS WITH HEALTH MAINTENANCE ORGANIZATIONS (HMOS) & PREPAID HEALTH PLANS
 
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 HCFA-R-27 No No
Form R-28 No No


    

90 0
   
State, Local, and Tribal Governments
 
   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 90 0 0 90 0 0
Annual IC Time Burden (Hours) 40,246 0 0 40,246 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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