OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

State Medicaid official-telephone interview

IC 227605 under ICR 201707-0990-001 · OMB 0990-0461.

Documents and Forms
Document Name
Document Type
Other-evaluation
Other-interview
Other-interview
Information Collection (IC) Details

View Information Collection (IC)

State Medicaid official-telephone interview
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-evaluation Attachment E CCBHC Evaluation Baseline State Medicaid Official Interview_OMB.docx No   Paper Only
Other-interview Attachment G CCBHC Evaluation Midpoint State Medicaid Official Interview.docx No   Paper Only
Other-interview Attachment I CCBHC Evaluation End State Medicaid Official Interview.docx No   Fillable Fileable

Health Health Care Services

 

8 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 48 0 48 0 0 0
Annual IC Time Burden (Hours) 48 0 48 0 0 0
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.