Proper Claim Not Filed and Supporting Regulation Contained in 42 CFR 411.32(c)

Proper Claim Not Filed and Supporting Regulation Contained in 42 CFR 411.32(c)

OMB: 0938-0564

IC ID: 8150

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Proper Claim Not Filed and Supporting Regulation Contained in 42 CFR 411.32(c)
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-R-136 Yes Yes


    

13,311 0
   
Private Sector Businesses or other for-profits
 
   80 %

  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 13,311 0 13,311 0 0 0
Annual IC Time Burden (Hours) 1 0 1 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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