Provider Dispute Notice

Expanded Access to Non-VA Care through the MISSION Program: Establishing a Process for Certification, Discontinuance, and Disputes for Veterans Care Agreements (VCAs) - AQ45

OMB: 2900-0872

IC ID: 235326

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Provider Dispute Notice 2900-NEW
 
No New
 
Mandatory
 
38 CFR 17.4100

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

54VA16, Health Administration Center Civilian Health and Medical Program Records-VA  74 FR 34398

803 0
   
Private Sector Businesses or other for-profits
 
   75 %

  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 803 0 803 0 0 0
Annual IC Time Burden (Hours) 268 0 268 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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