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Information Collection

Information Collection Requirements In Bpo-500-f, Third-party Liability For Medical Assistance, Ffp Rates For Skilled Professional Medical Personnel And Supporting Staff

IC 113782 under ICR 199411-0938-004 · OMB 0938-0459.

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INFORMATION COLLECTION REQUIREMENTS IN BPO-500-F, THIRD-PARTY LIABILITY FOR MEDICAL ASSISTANCE, FFP RATES FOR SKILLED PROFESSIONAL MEDICAL PERSONNEL AND SUPPORTING STAFF
 
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 HCFA-R-78 No No


    

52 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 52 0 52 0 0 0
Annual IC Time Burden (Hours) 52 0 52 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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