Information Collection Request
[Medicaid] Annual State Report on Value Based Purchasing Arrangements (VBP) Supplemental Rebate Agreements (CMS-10722)
ICR 202405-0938-003 · OMB 0938-1385 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10722 Annual State Report on CMS VBP Supplemental Rebate Agreements |
Form | Modified | Repair queued |
 CMS-10722 - Supporting Statement A (2024 version 4).docx |
Supporting Statement A | Uploaded 2024-05-03 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 242409 |  Annual State Report on CMS VBP Supplemental Rebate Agreements |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1385 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202106-0938-006 |
| Agency Tracking No | CMCS |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |