GenIC #45 (Extension w/o change): Maternal and Infant Health Quality

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

OMB: 0938-1148

IC ID: 229715

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GenIC #45 (Extension w/o change): Maternal and Infant Health Quality
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #1 (Women) MIH_2015_by Women_1.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #3 (Women) MIH_2015_by Women_3.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #1 (Postpartum Women) MIH_2015_Postpartum Women_1.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #6 (Women) MIH_2015_by Women_6.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #2 (Postpartum Women) MIH_2015_Postpartum Women_2.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #3 (Postpartum Women) MIH_2015_Postpartum Women_3.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #4 (Postpartum Women) MIH_2015_Postpartum Women_4.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #5 (Postpartum Women) MIH_2015_Postpartum Women_5.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #6 (Postpartum Women) MIH_2015_Postpartum Women_6.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #7 (Postpartum Women) MIH_2015_Postpartum Women_7.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #8 (Postpartum Women) MIH_2015_Postpartum Women_8.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #9 (Postpartum Women) MIH_2015_Postpartum Women_9.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #10 (Postpartum Women) MIH_2015_Postpartum Women_10.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #2 (Women) MIH_2015_by Women_2.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #4 (Women) MIH_2015_by Women_4.pdf Yes Yes Fillable Fileable
Form CMS-10398 #45 Maternal and Infant Health (MIH) Quality Screenshot #5 (Women) MIH_2015_by Women_5.pdf 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 112 0 112 0 0 0
Annual IC Time Burden (Hours) 112 0 112 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
#45 - Supporting Statement 45 - Supporting Statement MIH Quality.docx 01/12/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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