GenIC #2 (Extension w/o change): Medicaid Managed Care Data Collection

Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)

OMB: 0938-1148

IC ID: 229605

Documents and Forms
Information Collection (IC) Details

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GenIC #2 (Extension w/o change): Medicaid Managed Care Data Collection
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Att 1-NSDD2011f.docx Yes Yes Fillable Fileable
Instruction Att 2-2011ERDDf.docx Yes Yes Fillable Fileable

Health Health Care Services

 

56 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested 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 56 0 56 0 0 0
Annual IC Time Burden (Hours) 2,240 0 2,240 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GenIC #2 - Supporting Statement 2 - Medicaid Managed Care Data Collection revised.docx 12/29/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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