Information Collection

GenIC #37 (Extension w/o change): Managed Care Rate Setting Guidance

IC 229711 under ICR 201712-0938-019 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
37 - Medicaid Rate Guide Effective 7.1.17 to 6.30.18 - 03.29.2017 - clean.docx Instruction
37 - Managed Care Rates Supporting Statement Final 1-10 [rev 01-25-2017 by OSORA PRA].docx #37 - Supporting Statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	GenIC #37 (Extension w/o change): Managed Care Rate Setting Guidance	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			37 - Medicaid Rate Guide Effective 7.1.17 to 6.30.18 - 03.29.2017 - clean.docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 42	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	70	70
Annual IC Time Burden (Hours)	280	280
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
#37 - Supporting Statement	37 - Managed Care Rates Supporting Statement Final 1-10 [rev 01-25-2017 by OSORA PRA].docx	01/11/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.