Follow-Up of Medicare+Choice Disenrollees Receiving Fee-for-Service Inpatient Hospital Care

Follow-Up of Medicare+Choice Disenrollees Receiving Fee-for-Service Inpatient Hospital Care

OMB: 0938-0820

IC ID: 8613

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

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Follow-Up of Medicare+Choice Disenrollees Receiving Fee-for-Service Inpatient Hospital Care
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-10017 No No


    

500 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 500 0 500 0 0 0
Annual IC Time Burden (Hours) 542 0 542 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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