State Medicaid Eligibility Quality Control Sampling Plan

State Medicaid Eligibility Quality Control Sampling Plan

OMB: 0938-0146

IC ID: 43651

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State Medicaid Eligibility Quality Control Sampling Plan
 
No Unchanged
 
Mandatory
 
42 CFR 431.800 - 431.865

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

Health Health Care Services

 

10 0
   
State, Local, and Tribal Governments
 
   90 %

  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 20 0 0 0 0 20
Annual IC Time Burden (Hours) 480 0 0 0 0 480
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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