Information Collection

Evaluation of Five State Health Care Reform Demonstrations and the Evaluation of the Medicaid State Health Reform

IC 8348 under ICR 199709-0938-006 · OMB 0938-0708.

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Information Collection (IC) Details

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IC Title:	Evaluation of Five State Health Care Reform Demonstrations and the Evaluation of the Medicaid State Health Reform	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-R-207				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 33,693	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	34,035	34,035
Annual IC Time Burden (Hours)	10,279	10,279
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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