PACE State Plan Option Preprint (CMS-10227)

PACE State Plan Amendment Pre-print (CMS-10227)

OMB: 0938-1027

IC ID: 181912

Information Collection (IC) Details

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PACE State Plan Option Preprint (CMS-10227)
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10227 PACE State Plan Option Preprint CMS-10227 SPA PACE PREPRINT.doc No No Fillable Printable
Instruction SMDL-11-09-00.tif No No Printable Only

Health Health Care Services

 

36 0
   
State, Local, and Tribal Governments
 
   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 36 0 0 0 36 0
Annual IC Time Burden (Hours) 240 0 0 0 240 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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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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