Agency Characteristics Form For The National Home Health Agency Prospecitive Payment Demonstration

AGENCY CHARACTERISTICS FORM FOR THE NATIONAL HOME HEALTH AGENCY PROSPECITIVE PAYMENT DEMONSTRATION

OMB: 0938-0569

IC ID: 114000

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

View Information Collection (IC)

AGENCY CHARACTERISTICS FORM FOR THE NATIONAL HOME HEALTH AGENCY PROSPECITIVE PAYMENT DEMONSTRATION
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-443 No No
Form HCFA-444 No No


    

111 0
   
Private Sector Businesses or other for-profits
 
   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 111 0 111 0 0 0
Annual IC Time Burden (Hours) 72 0 72 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

© 2024 OMB.report | Privacy Policy