Information Collection Request

Medicaid State Program Integrity (SPIA) CMS-10244

ICR 200711-0938-013 · OMB 0938-1033 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Appendix B - Draft SPIA Data Collection Instrument w_track changes.doc Supplementary Document Uploaded 2007-10-31 Repair queued
Revisions to SPIA OMB Clearance Package.doc Supplementary Document Uploaded 2007-10-31 Available
CMS Response to SPIA Comments 10-10-07.doc Supplementary Document Uploaded 2007-10-31 Available
Appendix E - 42 CFR 455.pdf Supplementary Document Uploaded 2007-10-31 Available
Appendix D - DRA of 2005 Section 6034.pdf Supplementary Document Uploaded 2007-10-31 Available
Appendix A - SPIA Case Study Pilot Summary.doc Supplementary Document Uploaded 2007-10-31 Available
Appendix C - DRAFT Medicaid Integrity Glossary 10-10-07.doc Supplementary Document Uploaded 2007-10-31 Available
SPIA Supporting Statement revised 10-10-07.doc Supporting Statement A Uploaded 2007-10-31 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
182825 Medicaid State Program Integrity Assessment (SPIA) CMS-10244 Other-Information Management System New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2011 36 Months From Approved
56 0 0
1,400 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Medicaid State Program Integrity Assessment (SPIA) CMS-10244

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 56 0 0 56 0 0
Annual Time Burden (Hours) 1,400 0 0 1,400 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No