Medicaid Use Report (final Regulation)

MEDICAID USE REPORT (FINAL REGULATION)

OMB: 0960-0267

IC ID: 115154

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

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MEDICAID USE REPORT (FINAL REGULATION)
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form F-20-416 No No
Form 268 No No


    

25,000 0
   
Individuals or Households
 
   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 25,000 0 25,000 0 0 0
Annual IC Time Burden (Hours) 1,250 0 1,250 0 0 0
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.

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