2023 Renewal: Extension without change of active collections of information (GenICs #1, #2, #3, #15, #22, #26, #45, #47, and #77)

Medicaid and CHIP Program (MACPro) (CMS-10434)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1188 can be found here:

Documents and Forms

Document Name Document Type
Inventory of Active GenICs.pdf Other-Active GenICs Forms and Supple
Inventory of Active GenICs.pdf Other-Active GenICs Forms and Supple

Information Collection (IC) Details

IC Title:	2023 Renewal: Extension without change of active collections of information (GenICs #1, #2, #3, #15, #22, #26, #45, #47, and #77)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Active GenICs Forms and Supplemental Documents			Inventory of Active GenICs.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	696	696
Annual IC Time Burden (Hours)	20,712	20,712
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.