Information Collection

Matching Gants to States for the Operation of High Risk Pools and Supporting Regulations at 42 CFR 148.316, 148.318, and 148.320

IC 8715 under ICR 201303-0938-015 · OMB 0938-0887.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CMS HRP Law Overview.doc CMS HRP Law Overview	IC Document
HRP LAW THOMAS.doc HRP LAW THOMAS	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 148.320 42 CFR 148.316 42 CFR 148.318

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 31

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	31	31
Annual IC Time Burden (Hours)	1,240	1,240
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CMS HRP Law Overview	CMS HRP Law Overview.doc	12/01/2006
HRP LAW THOMAS	HRP LAW THOMAS.doc	12/01/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.