Information Collection

#37 (2016 Managed Care Rate Setting Guidance)

IC 218045 under ICR 201410-0938-016 · OMB 0938-1148.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1148 can be found here:

Documents and Forms

Document Name Document Type
37 - 2016 Medicaid Rate Guide final 7-16-15_OMBedits.doc Instruction
37 - Copy of Crosswalk 2016 Rate Guide.xlsx Other-Crosswalk
37 - Supporting Statement 2016 Managed Care Rate Setting Guidance.docx 37 - Supporting Statement 2016 Managed Care Rate Setting Guidance IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	#37 (2016 Managed Care Rate Setting Guidance)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			37 - 2016 Medicaid Rate Guide final 7-16-15_OMBedits.doc		Yes	Yes	Fillable Printable
Other-Crosswalk			37 - Copy of Crosswalk 2016 Rate Guide.xlsx		No		Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 70	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 Agency Discretion
Annual Number of Responses for this IC	70	70
Annual IC Time Burden (Hours)	140	140
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
37 - Supporting Statement 2016 Managed Care Rate Setting Guidance	37 - Supporting Statement 2016 Managed Care Rate Setting Guidance.docx	09/16/2015

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