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Medicare+Choice Provider Sponsored Organization Waiver Request Form and Supporting Regulations at 42 CFR 422.370 through 422.378

IC 8382 under ICR 200107-0938-008 · OMB 0938-0722.

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Medicare+Choice Provider Sponsored Organization Waiver Request Form and Supporting Regulations at 42 CFR 422.370 through 422.378
 
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-231 No No


    

10 0
   
Private Sector Businesses or other for-profits
 
   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 10 0 0 -20 0 30
Annual IC Time Burden (Hours) 100 0 0 -200 0 300
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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