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Medicare Disproportionate Share Hospital (DSH) Payments: Counting Days Associated with Section 1115 Demonstrations in the Medicaid Fraction

IC 260509 under ICR 202308-0938-014 · OMB 0938-1447.

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Medicare Disproportionate Share Hospital (DSH) Payments: Counting Days Associated with Section 1115 Demonstrations in the Medicaid Fraction
 
No Modified
 
Voluntary
 
42 CFR 412.106

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction CMS-10839.Instructions for Worksheet S2.pdf Yes No Printable Only

Health Health Care Services

 

340 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 1,904,968 0 1,904,968 0 0 0
Annual IC Time Burden (Hours) 494,536 0 494,536 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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