Annual State Report and Annual State Performance Rankings (CMS-10241)

Annual State Report and Annual State Performance Rankings (CMS-10241)

OMB: 0938-1041

IC ID: 183391

Information Collection (IC) Details

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Annual State Report and Annual State Performance Rankings (CMS-10241)
 
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 and Instruction CMS-10241 State Payment and Utilization Rates and Performance Rankings Data Collection Form CMS-10241-CMSStatesAnalysisdatacollectiontemplate v4.xls Yes Yes Fillable Printable

Health Health Care Services

 

51 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 51 51 0 0 0 0
Annual IC Time Burden (Hours) 765 765 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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