States - Data Collection

Health Care Reform Insurance Web Portal Requirements 45 CFR part 159 (CMS-10320)

OMB: 0938-1086

IC ID: 199275

Information Collection (IC) Details

View Information Collection (IC)

States - Data Collection
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10320 State instructions and instruments CMS-10320.FINAL State Instructions and Instrument.pdf No   Paper Only
Instruction CMS-10320 Appendix_E_State Requirements.pdf Yes No Paper Only

Health Health Care Services

 

50 0
   
State, Local, and Tribal Governments
 
   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 50 0 0 0 0 50
Annual IC Time Burden (Hours) 400 0 0 0 0 400
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Data Collection Template CMS 10320 Appendix G_2020 .xlsm 01/28/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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