MEDICAID PROGRAM BUDGET REPORT

ICR 199209-0938-007

OMB: 0938-0101

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
112886 Migrated
ICR Details
0938-0101 199209-0938-007
Historical Active 199103-0938-004
HHS/CMS
MEDICAID PROGRAM BUDGET REPORT
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 12/23/1992
Retrieve Notice of Action (NOA) 09/25/1992
This information collection is approved through 6-93 under the following condition: HCFA will submit to OMB, on or before 6-93 a new form for the HCFA 37 that elicits sufficient information for HCFA to determine State complicance with the Medicaid Voluntary Contribution and Provider Specific Taxes Law, P.L.102-234.
  Inventory as of this Action Requested Previously Approved
06/30/1993 06/30/1993
228 0 0
7,980 0 0
0 0 0

THE MEDICAID PROGRAM BUDGET REPORT (FORM HCFA-25 IS PREPARED BY THE STATE MEDICAID AGENCIES AND IS USED BY HCFA FOR (1) DEVELOPING NATIONAL MEDICAID BUDGET ESTIMATES, (2) QUANTIFICATION OF BUDGET ASSUMPTIONS, AND (3) THE ISSUANCES OF QUARTERLY MEDICAID GRANT AWARDS.

None
None


No

1
IC Title Form No. Form Name
MEDICAID PROGRAM BUDGET REPORT HCFA-37

  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 228 0 0 228 0 0
Annual Time Burden (Hours) 7,980 0 0 7,980 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
09/25/1992


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