Information Collection Request

Section 1115 Demonstration Projects Regulations at 42 CFR 431.408, 431.412, 431.420, 431.424, and 431.428 (CMS-10341)

ICR 202111-0938-009 · OMB 0938-1162 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS Response to NHeLP Comment_SDG cleared final 11 9 21.docx Supplementary Document Uploaded 2021-11-30 Available
CMS-10341 - Supporting Statement A (2021 version 5).docx Supporting Statement A Uploaded 2021-11-30 Available

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2025 36 Months From Approved 01/31/2022
403 0 300
41,874 0 24,092
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 403 300 0 0 103 0
Annual Time Burden (Hours) 41,874 24,092 0 0 17,782 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No