Periodic Renewal of Medicaid and CHIP Eligibility - Pre-Populated Renewal Form (sections 435.916, 457.343, and 457.350)

Medicaid Program; Eligibility Changes under the Affordable Care Act of 2010 (CMS-10410)

OMB: 0938-1147

IC ID: 199158

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Periodic Renewal of Medicaid and CHIP Eligibility - Pre-Populated Renewal Form (sections 435.916, 457.343, and 457.350)
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
42 CFR 457.343 and 457.350 42 CFR 435.916

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

Health Health Care Services

 

25,500,000 0
   
Individuals or Households
 
   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 25,500,000 0 0 0 0 25,500,000
Annual IC Time Burden (Hours) 8,500,000 0 0 0 0 8,500,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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