Negative Case Action Review Schedule/action Summary Tables (medicaid Eligibility Quality Control)

NEGATIVE CASE ACTION REVIEW SCHEDULE/ACTION SUMMARY TABLES (MEDICAID ELIGIBILITY QUALITY CONTROL)

OMB: 0938-0300

IC ID: 113386

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NEGATIVE CASE ACTION REVIEW SCHEDULE/ACTION SUMMARY TABLES (MEDICAID ELIGIBILITY QUALITY CONTROL)
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA 6401 No No


    

51 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 8,600 0 0 0 0 8,600
Annual IC Time Burden (Hours) 7,353 0 0 -688 0 8,041
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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