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GenIC #64 (New): Federal Meta-Analysis Support: Section 1115 Substance Use Disorder Demonstrations

IC 242071 under ICR 201712-0938-019 · OMB 0938-1148.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Introductory Email: Demonstrat
Other-Confirmation Email: Demonstrat
Other-Outlook Invitation: Demonstrat
Other- Reminder Email: Demonstration
Other-Introductory Email: Implementa
Other- Email Invitation: Implementat
Other-Confirmation Email: Implementa
Other-Implementation Interview
Other- Reminder Email: Implementatio
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

GenIC #64 (New): Federal Meta-Analysis Support: Section 1115 Substance Use Disorder Demonstrations CMCS
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10398 #64 Demonstration Characteristics Interview Questions Attachment 1.c. Demonstration Characteristics Interview Questions_clean_5 June 2020.docx Yes Yes Fillable Fileable
Form and Instruction CMS-10398 #64 Implementation Interview Protocol with Instructions for Interviewer Attachment 2.f. Implementation Interview Protocol with Instructions for Interviewer_clean_5 June 2020.docx Yes Yes Fillable Fileable
Other-Introductory Email: Demonstration Characteristics Interview 64 - Attachment 1.a. Demo Characteristics Admin Intro Email from CMS to SMD_clean.docx Yes No Printable Only
Other-Confirmation Email: Demonstration Characteristics Interview 64 - Attachment 1.d. Demo Characteristics Interview Confirmation Email_clean.docx Yes No Printable Only
Other-Outlook Invitation: Demonstration Characteristics Interview 64 - Attachment 1.e. Demo Characteristics Interview Outlook Invitation_clean.docx Yes No Printable Only
Other- Reminder Email: Demonstration Characteristics Interview 64 - Attachment 1.f. Demonstration Characteristics Interview Reminder Email_clean.docx Yes Yes Printable Only
Other-Introductory Email: Implementation Interview 64 - Attachment 2.a. Email CMS to State Administrator Intro RTI Evaluation_clean.docx Yes No Printable Only
Other- Email Invitation: Implementation Interview 64 - Attachment 2.b. Implementation Interview Email Invitation_clean.docx Yes No Printable Only
Other-Confirmation Email: Implementation Interview 64 - Attachment 2.c. Implementation Interview Confirmation Email_clean.docx Yes No Printable Only
Other-Implementation Interview 64 - Attachment 2.d. Implementation Interview Outlook Invitation_clean.docx Yes No Printable Only
Other- Reminder Email: Implementation Interview 64 - Attachment 2.e. Implementation Interview Reminder Email_clean.docx Yes No Printable Only
Form and Instruction CMS-10398 #64 Demonstration Characteristics Interview Email Invitation and Grid Attachment 1.b. Demonstration Characteristics Interview Email Invitation_clean_ 5June 2020.docx Yes Yes Fillable Fileable

Health Health Care Services

 

27 0
   
State, Local, and Tribal Governments
 
   100 %

  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 54 0 54 0 0 0
Annual IC Time Burden (Hours) 162 0 162 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Supporting Statement 64 - Generic Supporting Statement (2020 version 4).docx 06/05/2020
Supporting Statement B 64 - Supporting Statement Part B_clean_5 June 2020.docx 06/05/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.