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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.