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Discussion Guides
Experiences with 1115 Medicaid Waivers relative to the Ryan White HIV/AIDS Program and Its Clients and Providers
OMB: 0915-0365
IC ID: 207739
OMB.report
HHS/HSA
OMB 0915-0365
ICR 201307-0915-002
IC 207739
( )
Documents and Forms
Document Name
Document Type
Form 1
Discussion Guides
Form and Instruction
1 State medicaid Agency Groups
B_Medicaid Discussion Guide.docx
Form and Instruction
2 RW Part A Administrators and Members of Planning Council
C_RW PART A Discussion Guide.docx
Form and Instruction
4 RW Clinical Providers
E_RW PART C Discussion Guide.docx
Form and Instruction
3 RW Part B and ADAP
D_RW PART B Discussion Guide.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Discussion Guides
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
State medicaid Agency Groups
B_Medicaid Discussion Guide.docx
Yes
Yes
Paper Only
Form and Instruction
2
RW Part A Administrators and Members of Planning Councils
C_RW PART A Discussion Guide.docx
Yes
Yes
Paper Only
Form and Instruction
4
RW Clinical Providers
E_RW PART C Discussion Guide.docx
Yes
Yes
Paper Only
Form and Instruction
3
RW Part B and ADAP
D_RW PART B Discussion Guide.docx
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
280
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
280
0
280
0
0
0
Annual IC Time Burden (Hours)
560
0
560
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.