Information Collection Request
Medicare Disproportionate Share Hospital (DSH) Payments: Counting Days Associated With Section 1115 Demonstrations in the Medicaid Fraction (CMS-10839)
ICR 202305-0938-013 · OMB 0938-1447 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1447 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 CMS-10839.Supporting Statement Part A.docx |
Supporting Statement A | Uploaded 2023-06-02 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 260509 |  Medicare Disproportionate Share Hospital (DSH) Payments: Counting Days Associated with Section 1115 Demonstrations in the Medicaid Fraction |
New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1447 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Agency Tracking No | CM |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |