Information Collection

Emergency Reinstatement

IC 269358 under ICR 202407-0938-005 · OMB 0938-1148.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1148 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Total Inventory NOA (issued 04-26-2024).pdf	Other-
Total Inventory NOA (issued 04-26-2024).pdf	Other-
CMS-10398 Reinstat Reinstatement Inventory Reinstatement Inventory.docx	Form and Instruction
CMS-10398 Reinstat Reinstatement Inventory Reinstatement Inventory.docx	Form and Instruction

IC Title:

Emergency Reinstatement

Agency IC Tracking Number:

CMCS

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-			Total Inventory NOA (issued 04-26-2024).pdf		Yes	Yes	Fillable Fileable
Form and Instruction	CMS-10398 Reinstated GenICs	Reinstatement Inventory	Reinstatement Inventory.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	360,136	360,136
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.