Information Collection

Certification of Medicaid Eligibilty Quality Control (MEQC) Payment Error Rates and Supporting Regulations at 42 CFR.431.800 through 431.865

IC 7904 under ICR 201308-0938-025 · OMB 0938-0246.

Documents and Forms

Document Name Document Type
Form CMS-301 Certification of Medicaid Eligibilty Quality Control (MEQC) Payment Error Rates and Supporting Regulations at 42 CFR.431.800 through 431.865 Form and Instruction
CMS-301 CMS-301.MEQC Annual Report CMS-301.MEQC Annual Report.DOC Form and Instruction
CMS-301 Certfication of Eligibility/Error Rate CMS-301 (2).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Certification of Medicaid Eligibilty Quality Control (MEQC) Payment Error Rates and Supporting Regulations at 42 CFR.431.800 through 431.865	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 431.800-865

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-301	CMS-301.MEQC Annual Report	CMS-301.MEQC Annual Report.DOC		Yes	No	Fillable Fileable
Form	CMS-301	Certfication of Eligibility/Error Rate	CMS-301 (2).pdf		Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 51	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	51	51
Annual IC Time Burden (Hours)	16,446	16,446
Annual IC Cost Burden (Dollars)	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.