OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Medicaid Enrollees and Disenrolles

IC 199534 under ICR 201110-0990-006 · OMB 0990-0384.

Documents and Forms
Document Name
Document Type
Other-survey
Other-study
Other-study
Other-study
Other-study
Information Collection (IC) Details

View Information Collection (IC)

Medicaid Enrollees and Disenrolles
 
No Removed
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-survey 0990-CHIP Part B_Attachment C_Pretest Report.pdf No No Paper Only
Other-study CHIP Part A_Attachment C2_Case Studies_Community Enrollment Agencies.pdf No No Paper Only
Other-study CHIP Part A_Attachment C3_Case Studies_Health Care Providers.pdf No No Paper Only
Other-study CHIP Part A_Attachment C1_Case Studies_State Officials.pdf No No Paper Only
Other-study 0990-CHIP Part A_Attachment C4_Case Studies_Managed Care and Health Plans.pdf No No Paper Only

Health Illness Prevention

 

4,500 0
   
Individuals or Households
 
   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 0 0 0 0 0 0
Annual IC Time Burden (Hours) 0 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.