Evaluation Requirements (431.424(e))

Medicaid Program; Review and Approval Process for Section 1115 Demonstrations

OMB: 0938-1162

IC ID: 196282

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Evaluation Requirements (431.424(e))
 
No Modified
 
Mandatory
 
42 CFR 431.424(e)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

15 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 15 15 0 0 0 0
Annual IC Time Burden (Hours) 1,050 1,050 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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