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Information Collection

Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (MEQC Substitution)

IC 190303 under ICR 201002-0938-008 · OMB 0938-1012.

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

View Information Collection (IC)

Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (MEQC Substitution)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10184D Detailed Payment Review Findings CMS 10184D MEQC substitution 7-8-09.doc Yes Yes Fillable Fileable
Form and Instruction CMS-10184A Cases Selected for Review: Monthly Sample Selection List CMS 10184A MEQC substitution 7-8-09.doc Yes Yes Fillable Fileable
Form and Instruction CMS-10184B Detailed Active Case Review Findings CMS 10184B MEQC substitution 7-8-09.doc Yes Yes Fillable Fileable
Form and Instruction CMS-10184E Summary Findings CMS 10184E MEQC substitution 7-8-09.doc Yes Yes Fillable Fileable

Health Health Care Services

 

19 0
   
State, Local, and Tribal Governments
 
   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 19 0 0 0 0 19
Annual IC Time Burden (Hours) 407,094 0 0 0 0 407,094
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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