State Medicaid HIT Plan and Templates for Implementation of Section 4201 of ARRA (CMS-10292)

State Medicaid HIT Plan and Template for Implementation of Section 4201 of ARRA (CMS-10292)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1088 can be found here:

Documents and Forms

Document Name Document Type
STATE MEDICAID HIT PLAN.pdf Other-State Medicaid Hit Plan
CMS-10292 Model Checklist: HIT P-APD Model HIT P-APD.pdf Form

Information Collection (IC) Details

IC Title:	State Medicaid HIT Plan and Templates for Implementation of Section 4201 of ARRA (CMS-10292)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-State Medicaid Hit Plan			STATE MEDICAID HIT PLAN.pdf		Yes	Yes	Fillable Fileable
Form	CMS-10292	Model Checklist: HIT P-APD	Model HIT P-APD.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	56	56
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.