MEDICAID MANAGEMENT INFORMATION SYSTEM (MMIS)

ICR 198610-0938-010

OMB: 0938-0247

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
113250 Migrated
ICR Details
0938-0247 198610-0938-010
Historical Active 198606-0938-015
HHS/CMS
MEDICAID MANAGEMENT INFORMATION SYSTEM (MMIS)
Extension without change of a currently approved collection   No
Regular
Approved without change 01/25/1987
Retrieve Notice of Action (NOA) 10/27/1986
  Inventory as of this Action Requested Previously Approved
10/31/1987 10/31/1987 09/30/1989
45 0 45
2,275,000 0 2,275,000
0 0 0

THE MEDICAID MANAGEMENT INFORMATION SYSTEM (MMIS) IS A STATE-OPERATED, FEDERALLY MANDATED, COMPUTER SYSTEM USED FOR MEDICAID CLAIMS PROCESSING AND PROGRAM MANAGEMENT. THESE DATA ELEMENTS REPRESENT THE FEDERALLY IMPOSED RECORDKEEPING REQUIREMENTS OF MMIS.

None
None


No

1
IC Title Form No. Form Name
MEDICAID MANAGEMENT INFORMATION SYSTEM (MMIS) HCFA-R-4

  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 45 45 0 0 0 0
Annual Time Burden (Hours) 2,275,000 2,275,000 0 0 0 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.
10/27/1986


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