CHIPRA Connecting Kids to Coverage Outreach and Enrollment Grants (CMS-10398; GenIC #7)

[Medicaid] Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)

OMB: 0938-1148

IC ID: 254145

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

View Information Collection (IC)

CHIPRA Connecting Kids to Coverage Outreach and Enrollment Grants (CMS-10398; GenIC #7)
 
Unchanged
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10398 (GenIC#7) CMS-10398_GenIC_7-CycleVaSAR508 CMS-10398_GenIC_7-CycleVaSAR508.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (GenIC#7) CMS-10398_GenIC_7-CycleVbFinalSAR508 CMS-10398_GenIC_7-CycleVbFinalSAR508.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (GenIC#7) CMS-10398_GenIC_7-CycleVbMonthlyReport508 CMS-10398_GenIC_7-CycleVbMonthlyReport508.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (GenIC#7) CMS-10398_GenIC_7-CycleVbMonthlyReportwAIANTarget CMS-10398_GenIC_7-CycleVbMonthlyReportwAIANTarget.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (GenIC#7) CMS-10398_GenIC_7-CycleVbMonthlyReportwTarget CMS-10398_GenIC_7-CycleVbMonthlyReportwTarget.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

47 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested 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 1,973 0 0 0 0 1,973
Annual IC Time Burden (Hours) 10,102 0 0 0 0 10,102
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10398_GenIC_7-SupportingStatement CMS-10398_GenIC_7-SupportingStatement.docx 06/09/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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