Information Collection

Medicaid Managed Care Regulations (States) 42 CFR 438.6, 438.10, 438.50, 438.202, 438.722, 438.724, and 438.810

IC 8764 under ICR 201912-0938-010 · OMB 0938-0920.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0920 can be found here:

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Information Collection (IC) Details

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IC Title:	Medicaid Managed Care Regulations (States) 42 CFR 438.6, 438.10, 438.50, 438.202, 438.722, 438.724, and 438.810	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 438.10 42 CFR 438.50 42 CFR 438.6 42 CFR 438.202 42 CFR 438.722 42 CFR 438.724 42 CFR 438.810

Information Collection Instruments:

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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 42	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,995,472	-95	3,995,567
Annual IC Time Burden (Hours)	93,269	-1,757	95,026
Annual IC Cost Burden (Dollars)	0	0	0

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