Medicaid-Integrated Quality Control Review Manual Instructions and Supporting Regulations -- 42 CFR 431.800, .865

ICR 199804-0938-004

OMB: 0938-0094

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0094 199804-0938-004
Historical Active 199405-0938-003
HHS/CMS
Medicaid-Integrated Quality Control Review Manual Instructions and Supporting Regulations -- 42 CFR 431.800, .865
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 06/08/1998
Retrieve Notice of Action (NOA) 04/10/1998
  Inventory as of this Action Requested Previously Approved
06/30/2001 06/30/2001
21 0 0
1 0 0
0 0 0

The integrated quality control (QC) information collection requirements are used by State quality control reviewers to collect catagorical and financial information on a radomly selected sample of Medicaid cases to verify the correctness of Medicaid eligibility determinations.

None
None


No

1
IC Title Form No. Form Name
Medicaid-Integrated Quality Control Review Manual Instructions and Supporting Regulations -- 42 CFR 431.800, .865 HCFA-316

  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 21 0 0 21 0 0
Annual Time Burden (Hours) 1 0 0 1 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.
04/10/1998


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