Medicaid Disproportionate Share Hospital Annual Reporting

Medicaid Disproportionate Share Hospital Annual Reporting

OMB: 0938-0746

IC ID: 8445

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Medicaid Disproportionate Share Hospital Annual Reporting
 
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 R-266 Yes Yes


    

52 0
   
State, Local, and Tribal Governments
 
   100 %

  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 52 0 -2 0 0 54
Annual IC Time Burden (Hours) 1,976 0 -184 0 0 2,160
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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