Corrective Action Plans (Self-Insured Non-Federal Governmental Plans and Issuers)

Non-Quantitative Treatment Limitation Analyses and Compliance Under MHPAEA (CMS-10773)

OMB: 0938-1393

IC ID: 246612

Documents and Forms
Document Name
Document Type
Other-Guidance
Information Collection (IC) Details

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Corrective Action Plans (Self-Insured Non-Federal Governmental Plans and Issuers)
 
No New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Guidance CMS-10773 Appendix I - FAQs-Part-45.docx Yes No Paper Only

Health Health Care Services

 

8 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   0 %

  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 8 8 0 0 0 0
Annual IC Time Burden (Hours) 200 200 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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