Periodic Renewal of Medicaid and CHIP Eligibility - Pre-Populated Renewal Form (sections 435.916, 457.343, and 457.350)

Medicaid Program; Eligibility Changes under the Affordable Care Act of 2010 (CMS-10410)

OMB: 0938-1147

IC ID: 199158

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

View Information Collection (IC)

Periodic Renewal of Medicaid and CHIP Eligibility - Pre-Populated Renewal Form (sections 435.916, 457.343, and 457.350)
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
42 CFR 435.916 42 CFR 457.343 and 457.350

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

25,500,000 0
   
Individuals or Households
 
   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 25,500,000 0 0 0 0 25,500,000
Annual IC Time Burden (Hours) 8,500,000 0 0 0 0 8,500,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

© 2024 OMB.report | Privacy Policy