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Information Collection

Medicaid Eligibility Quality Control - Information Collection Requirements In 42 Cfr 431.804(d)(3) And (4)

IC 113475 under ICR 198912-0938-002 · OMB 0938-0344.

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Information Collection (IC) Details

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MEDICAID ELIGIBILITY QUALITY CONTROL - INFORMATION COLLECTION REQUIREMENTS IN 42 CFR 431.804(D)(3) AND (4)
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-R-37 No No


    

10 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 10 0 0 0 0 10
Annual IC Time Burden (Hours) 2,316 0 0 0 0 2,316
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.