Medicare and Medicaid; Programs For All-Inclusive Care For The Elderly (PACE) Contained in 42 CFR 460.12-460.210

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0790 can be found here:

Documents and Forms

Document Name Document Type
Justification for ER PRA Clearance 10 24 06JP.doc Emergency Justification IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medicare and Medicaid; Programs For All-Inclusive Care For The Elderly (PACE) Contained in 42 CFR 460.12-460.210	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 460.68(b)(1) 42 CFR 460.68(b)(2)

Information Collection Instruments:

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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 2

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	54	0	54	0
Annual IC Time Burden (Hours)	8,229	54	8,440	-265
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Emergency Justification	Justification for ER PRA Clearance 10 24 06JP.doc	11/09/2006

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