Information Collection Request
Medicaid Disproportionate Share Hospital Annual Reporting (CMS-R-266)
ICR 202404-0938-003 · OMB 0938-0746 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-R-266 Medicaid Disproportionate Share Hospital (DSH) Annual Report |
Form | Modified | Repair queued |
 CMS-R-266 - Supporting Statement A (CMS-2445-F version 3).docx |
Supporting Statement A | Uploaded 2024-04-03 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 8445 |  Medicaid Disproportionate Share Hospital (DSH) Annual Report |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0746 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202309-0938-010 |
| Agency Tracking No | CMCS |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |