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Required Notice for Reinstatements Based on Beneficiary Cancellation of New Enrollment ((§§ 422.60 and 423.32))

IC 270344 under ICR 202512-0938-014 · OMB 0938-1378.

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Required Notice for Reinstatements Based on Beneficiary Cancellation of New Enrollment ((§§ 422.60 and 423.32))
 
No Modified
 
Mandatory
 
42 CFR 423.32 42 CFR 422.60

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

761 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   85 %

  Approved 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 225,906 0 0 0 0 225,906
Annual IC Time Burden (Hours) 3,840 0 0 0 0 3,840
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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