Information Collection

Medicaid Managed Care Regulations (CMS-10108)

IC 179886 under ICR 200704-0938-013 · OMB 0938-0920.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0920 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Medicaid Managed Care Regulations (CMS-10108)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 438.404 42 CFR 438.406 42 CFR 438.408 42 CFR 438.410 42 CFR 438.414 42 CFR 438.416 42 CFR 438.604 42 CFR 438.710 42 CFR 438.402 42 CFR 438.6 42 CFR 438.8 42 CFR 438.10 42 CFR 438.12 42 CFR 438.50 42 CFR 438.56 42 CFR 438.102 42 CFR 438.114 42 CFR 438.202 42 CFR 438.204 42 CFR 438.206 42 CFR 438.207 42 CFR 438.240 42 CFR 438.242 42 CFR 438.722 42 CFR 438.724 42 CFR 438.810

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: 326	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 1 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,549,991	2,549,991
Annual IC Time Burden (Hours)	3,555,927	3,555,927
Annual IC Cost Burden (Dollars)	23,357,918	23,357,918

Documents for IC

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