Information Collection Request

External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364 (CMS-R-305)

ICR 201206-0938-003 · OMB 0938-0786 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
B Supporting Statement 6-4-12.docx Supporting Statement B Uploaded 2012-06-13 Available
Protocol Summary Memo 051512 clean - approved for OSORA.docx Supplementary Document Uploaded 2012-06-13 Available
EQR Protocols - Response to Comments to OMB 5-15-12.docx Supplementary Document Uploaded 2012-06-13 Available
5-11-12 Final Edits to EQR Draft Protocols based on Public Comments.docx Supplementary Document Uploaded 2012-06-13 Available
CMS-R-305 Supporting Statement A [rev 06-13-2012].docx Supporting Statement A Uploaded 2012-06-13 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8551 External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364 Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2015 36 Months From Approved 10/31/2012
70 0 14,226
415,643 0 648,877
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 70 14,226 30 0 -14,186 0
Annual Time Burden (Hours) 415,643 648,877 178,140 0 -411,374 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No