Request for Accelerated Payments Supporting Regs in 42 CFR, section 412.116(f), 412.632(e), 413.64(g), 413.350(d) & 484.245

Request for Accelerated Payments Supporting Regs in 42 CFR, section 412.116(f), 412.632(e), 413.64(g), 413.350(d) & 484.245

OMB: 0938-0269

IC ID: 7921

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

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Request for Accelerated Payments Supporting Regs in 42 CFR, section 412.116(f), 412.632(e), 413.64(g), 413.350(d) & 484.245
 
No Modified
 
Mandatory
 
42 CFR 412.116(f) 42 CFR 412.632(e) 42 CFR 413.64(g) 42 CFR 413.350(d) 42 CFR 484.245

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction CMS-9042 Provder Reimbursement Manual 2412 to 2412 5.doc Yes Yes Paper Only

Health Health Care Services

 

880 0
   
Private Sector Businesses or other for-profits
 
   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 880 0 0 58 0 822
Annual IC Time Burden (Hours) 440 0 0 29 0 411
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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