Initial Year

Program Integrity Portal FWA Reporting Module - Part C Plans (CMS-10724)

OMB: 0938-1383

IC ID: 240008

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

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Initial Year
 
No New
 
Mandatory
 
42 CFR 422.503

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

Health Health Care Services

 

605 0
   
Private Sector Businesses or other for-profits
 
   100 %

  Requested 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 605 605 0 0 0 0
Annual IC Time Burden (Hours) 149,435 149,435 0 0 0 0
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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