MPAF Data and Supporting Regulations in 42 CFR Sections 413.337, 413.343, 424.32 and 483.20

MPAF Data and Supporting Regulations in 42 CFR Sections 413.337, 413.343, 424.32 and 483.20

OMB: 0938-0739

IC ID: 188651

Information Collection (IC) Details

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MPAF Data and Supporting Regulations in 42 CFR Sections 413.337, 413.343, 424.32 and 483.20
 
No New
 
Required to Obtain or Retain Benefits
 
42 CFR 413.337 42 CFR 413.343 42 CFR 424.32 42 CFR 483.20

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-R-250 MDS Medicare PPS Assessment Form MDS20MDSAllForms 31.pdf Yes Yes Paper Only
Other-Form page 2 MDS20MDSAllForms 32.pdf Yes Yes Paper Only
Other-Form page 3 MDS20MDSAllForms 33.pdf Yes Yes Paper Only
Other-Form page 4 MDS20MDSAllForms 34.pdf Yes Yes Paper Only
Other-Form page 5 MDS20MDSAllForms 35.pdf Yes Yes Paper Only

Health Health Care Services

 

734 353
   
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 187,170 0 0 187,170 0 0
Annual IC Time Burden (Hours) 132,011 0 0 132,011 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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