The Fiscal Soundness Reporting Requirements (CMS-906)

The Fiscal Soundness Reporting Requirements

OMB: 0938-0469

IC ID: 8094

Information Collection (IC) Details

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The Fiscal Soundness Reporting Requirements (CMS-906)
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 516(a)(5) 42 CFR 460.208 42 CFR 423.514  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-906 Health Plan Management System (HPMS) Collection Instrument and Instructions_OMB 0938-0469.pdf Yes Yes Fillable Fileable Signable
Instruction HPMS_FSM_Plan_User_Guide.pdf No   Printable Only
Other-null HPMS-FSM_PRA Disclosure Statement.pdf Yes Yes Printable Only

Health Health Care Services

 

767 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 1,589 0 71 0 0 1,518
Annual IC Time Burden (Hours) 530 0 24 0 0 506
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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