ICR'S CONTAINED IN 42 CFR, SECTIONS 441.56(D), 441.60(A)(4) AND (5), AND 441.61(A)

ICR 198707-0938-005

OMB: 0938-0354

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0938-0354 198707-0938-005
Historical Active 198405-0938-010
HHS/CMS
ICR'S CONTAINED IN 42 CFR, SECTIONS 441.56(D), 441.60(A)(4) AND (5), AND 441.61(A)
Revision of a currently approved collection   No
Regular
Approved without change 10/13/1987
Retrieve Notice of Action (NOA) 07/28/1987
Approved through 9/90 with the inclusion of section 441.60(c) which also includes information reporting requirements.
  Inventory as of this Action Requested Previously Approved
09/30/1990 09/30/1990 07/31/1987
54 0 54
3,002 0 14,450
0 0 0

REGULATION REQUIRES STATES TO INFORM ALL MEDICAID RECIPIENTS ELIGIBLE FOR EPSDT, OF EPSDT AVAILABILITY IF REQUESTED AND PROVIDE OR ARRANGE FOR SCREENING SERVICES, DIAGNOSIS AND CORRECTIVE TREATMENT OF HEALTH PROBLEMS DETECTED AS A RESULT OF THE SCREENING.

None
None


No

1
IC Title Form No. Form Name
ICR'S CONTAINED IN 42 CFR, SECTIONS 441.56(D), 441.60(A)(4) AND (5), AND 441.61(A)

  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 54 54 0 0 0 0
Annual Time Burden (Hours) 3,002 14,450 0 -11,448 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
07/28/1987


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