Revisions Crosswalk (Form CMS-R-199)
Issue # |
Page # |
Section |
Action to be performed |
Changes to the Application |
Reason for the Change |
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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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Page
File Type | application/msword |
File Title | Issue # |
Author | CMS |
Last Modified By | CMS |
File Modified | 2011-10-31 |
File Created | 2011-10-31 |