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CMS-10398 (#19) Eligibility and Enrollment Performance Indicator Monthly
Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions
# 19 - MonthlyReportForm-State
Bundle: Performance Indicators (# 19), Payment Suspension (# 30), and 1115 Demo (# 38)
OMB: 0938-1148
OMB.report
HHS/CMS
OMB 0938-1148
ICR 201111-0938-009
IC 213646
CMS-10398 (#19) Eligibility and Enrollment Performance Indicator Monthly
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1148 can be found here:
2024-09-27 - Reinstatement with change of a previously approved collection
2024-07-11 - Reinstatement without change of a previously approved collection
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File Modified
2014-09-03
File Created
2014-09-03
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