GenIC #7 (Revision): Connecting Kids to Coverage Outreach and Enrollment

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

OMB: 0938-1148

IC ID: 256905

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

View Information Collection (IC)

GenIC #7 (Revision): Connecting Kids to Coverage Outreach and Enrollment CMCS
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10398 #7 Semi-Annual Report Template ATTACHMENT 1-Semi-Annual Report Template508.pdf Yes Yes Fillable Fileable
Form CMS-10398 #7 Final Report Template ATTACHMENT 2-Final Report Template508.pdf Yes Yes Fillable Fileable
Form CMS-10398 #7 HK2019 and HK2020 Monthly Progress Report Template ATTACHMENT 3-HK2019 and HK2020 Monthly Progress Report Template508.pdf Yes Yes Fillable Fileable
Form CMS-10398 #7 HK2019 Monthly Progress Report with Targets Template ATTACHMENT 4-Monthly Progress Report with Targets.pdf Yes Yes Fillable Fileable
Form CMS-10398 #7 HK2022 and HK2023 Monthly Progress Report Template ATTACHMENT 5-HK2022 and HK2023 Monthly Progress Report Template.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

91 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 1,365 0 0 0 0 1,365
Annual IC Time Burden (Hours) 7,826 0 0 0 0 7,826
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Supporting Statement GenIC_7-Generic SupportingStatement_(2022 version 14).docx 12/13/2022
Track Change - HK2022 and HK2023 Monthly Progress Report Template Track Change - Attachment 5 - HK2022 and HK2023 Monthly Progress Report Template.pdf 12/13/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
© 2024 OMB.report | Privacy Policy