CMS-R-199 Crosswalk for Revisions

CMS-R-199 Crosswalk for Revisions.doc

Medicaid Report on Payables and Receivables

CMS-R-199 Crosswalk for Revisions

OMB: 0938-0697

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Revisions Crosswalk (Form CMS-R-199)



Issue #

Page #

Section

Action to be performed

Changes to the Application

Reason for the Change

All

Sections: I and II

Add a line to the form requesting additional information.

See change in Actions to be Performed column

Due to CFO audit request, an additional line is added to recast information. Please note that there is an increase of 1 hour in the burden calculation for information collection by the states.

































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File Typeapplication/msword
File TitleIssue #
AuthorCMS
Last Modified ByCMS
File Modified2011-10-31
File Created2011-10-31

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