Option to Cover Certain Children and Pregnant Women Lawfully Residing in the U.S. State Plan Amendment Template (CMS-10299)

ICR 201002-0938-004

OMB: 0938-1082

Federal Form Document

ICR Details
0938-1082 201002-0938-004
Historical Active
HHS/CMS
Option to Cover Certain Children and Pregnant Women Lawfully Residing in the U.S. State Plan Amendment Template (CMS-10299)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 02/18/2010
Retrieve Notice of Action (NOA) 02/04/2010
  Inventory as of this Action Requested Previously Approved
02/28/2013 36 Months From Approved
51 0 0
51 0 0
0 0 0

This new option for State Medicaid and Children Health Insurance Programs (CHIP) was provided by Section 214 of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law 111-3, which amended section 1902 of the Social Security Act effective April 1, 2009. To select this option, a State Medicaid or CHIP agency will complete a template page and submit it for approval as part of a Medicaid or CHIP State plan amendment.

PL: Pub.L. 111 - 3 214 Name of Law: Medical assistance to aliens not lawfully admitted for permanent residence
  
PL: Pub.L. 111 - 3 214 Name of Law: Medical Assistance to aliens not lawfully admitted for permanent residence

Not associated with rulemaking

  74 FR 50973 10/02/2009
74 FR 67229 12/18/2009
No

  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 51 0 51 0 0 0
Annual Time Burden (Hours) 51 0 51 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This is a new collection.

$0
No
No
Uncollected
Uncollected
No
Uncollected
Melissa Musotto 4107866962

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/04/2010


© 2024 OMB.report | Privacy Policy