GenIC #48 (Extension w/o change): Section 223 Demonstration Programs to Improve Community Mental Health Services

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

⚠️ Notice: This information collection may be referencing outdated material.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
48 - BHCMeasureSpecificationsVol1(508).pdf Instruction
48 - BHCQMAppendicesVol2(508).pdf Instruction
CMS-10398 #48 Attachment B: Quality Measurement Data Reporting Templat Demonstration223Templates(508).xlsx Form
48 - Supporting Statement Section 223 Demonstration Programs 04-26-17.docx #48 - Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	GenIC #48 (Extension w/o change): Section 223 Demonstration Programs to Improve Community Mental Health Services	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			48 - BHCMeasureSpecificationsVol1(508).pdf	Yes	Yes	Printable Only
Form	CMS-10398 #48	Attachment B: Quality Measurement Data Reporting Templates	Demonstration223Templates(508).xlsx	Yes	Yes	Fillable Fileable
Instruction			48 - BHCQMAppendicesVol2(508).pdf	Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24	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	528	528
Annual IC Time Burden (Hours)	1,387	1,387
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
#48 - Supporting Statement	48 - Supporting Statement Section 223 Demonstration Programs 04-26-17.docx	01/12/2018

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