Information Collection

Corrective Action Plan, Medicaid Eligibility Quality Control

IC 7854 under ICR 199511-0938-005 · OMB 0938-0144.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Corrective Action Plan, Medicaid Eligibility Quality Control	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-320				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 51	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	51	51
Annual IC Time Burden (Hours)	20,400	20,400
Annual IC Cost Burden (Dollars)	187,341,000	187,341,000

Documents for IC

Title	Document	Date Uploaded

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