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Information Collection

Data Collection for Administering The PACE Health Survey To Beneficiaries Enrolled In The Dual Eligible Demonstrations, Minnesota Senior Health Options and Minnesota Disability Health..

IC 8734 under ICR 200305-0938-001 · OMB 0938-0899.

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Information Collection (IC) Details

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Data Collection for Administering The PACE Health Survey To Beneficiaries Enrolled In The Dual Eligible Demonstrations, Minnesota Senior Health Options and Minnesota Disability Health..
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10089 No No


    

2,600 0
   
Private Sector Not-for-profit institutions
 
   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 1,768 0 1,768 0 0 0
Annual IC Time Burden (Hours) 295 0 295 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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