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State Medicaid Eligibility Quality Control Samplling Plan and Supporting Regulations in 42 CFR 431.800 - 431.865
State Medicaid Eligibility Quality Control Samplling Plan and Supporting Regulations in 42 CFR 431.800 - 431.865
OMB: 0938-0146
IC ID: 7858
OMB.report
HHS/CMS
OMB 0938-0146
ICR 200211-0938-001
IC 7858
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0146 can be found here:
2020-11-13 - Reinstatement without change of a previously approved collection
2016-09-27 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
State Medicaid Eligibility Quality Control Samplling Plan and Supporting Regulations in 42 CFR 431.800 - 431.865
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
CMS-317
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
55
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 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
110
0
0
0
0
110
Annual IC Time Burden (Hours)
2,640
0
0
0
0
2,640
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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.