0938-1148 (CMS-10398) Change Worksheet Request

0938-1148 (CMS-10398) Change Worksheet Request.doc

Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions

0938-1148 (CMS-10398) Change Worksheet Request

OMB: 0938-1148

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Change Worksheet Request

Generic “Umbrella” PRA Package

CMS-10398, OMB 0938-1148


The burden that was requested and subsequently approved set out the annual burden when it should have set out the total 3-year burden. Consequently, we request that the number of Responses is corrected to read “3,360” and the Hour burden is corrected to read “86,240.” These changes will not affect our burden estimates since those estimates were set out in the ICR’s Supporting Statement.


We respectfully request approval of these changes within 3-weeks or by Friday, December 9, 2011. We understand this change will be submitted under the change worksheet process.   


File Typeapplication/msword
AuthorCMS
Last Modified ByMitch
File Modified2011-11-17
File Created2011-11-16

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