Home & Community Based Waiver Requests and Supporting Regulations; 42 CFR 440.180, 441.300-.310

Home & Community Based Waiver Requests and Supporting Regulations; 42 CFR 440.180 and 441.300 - 441.310 (CMS-8003)

OMB: 0938-0449

IC ID: 8072

Information Collection (IC) Details

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Home & Community Based Waiver Requests and Supporting Regulations; 42 CFR 440.180, 441.300-.310
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 440.180 42 CFR 441.300-310

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-8003 Application for a Section 1915(c) Home and Community-Based Services Waiver Waiver Application (2022 version 2).pdf Yes Yes Fillable Fileable
Instruction Instructions_TechnicalGuide_V3.6 revised 12-30-21.pdf No   Printable Only

Health Health Care Services

 

49 0
   
State, Local, and Tribal Governments
 
   100 %

  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 71 0 0 0 0 71
Annual IC Time Burden (Hours) 6,005 0 0 0 0 6,005
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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