State and Local governments

Medicare Prior Authorization of Power Mobility Devices (PMDs) Demonstration

OMB: 0938-1235

IC ID: 209056

Information Collection (IC) Details

View Information Collection (IC)

State and Local governments
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction CMS-10471.Background Research Discussion Guide.docx Yes No Fillable Fileable
Form and Instruction CMS-10471 Revised PMD Stakeholders Screening and Scheduling Guide Revised PMD Stakeholders Screening and Scheduling Guide.docx Yes No Fillable Fileable

Health Health Care Services

 

28 0
   
State, Local, and Tribal Governments
 
   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 28 0 0 0 0 28
Annual IC Time Burden (Hours) 35 0 0 0 0 35
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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