Information Collection Request

[Medicaid] Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204 (CMS-10391)

ICR 202601-0938-011 · OMB 0938-1134 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
List of Changes Made to the Template 01.14.2026.xlsx Supplementary Document Uploaded 2026-01-29 Available
Access_Rate_Reduction_Restructuring_Template_2026.xlsx Supplementary Document Uploaded 2026-01-29 Available
Comment - mkn-1jzv-5g4s.pdf Public Comments Uploaded 2026-01-20 Repair queued
CMS-10391- Response to Public Comments (1.20.2026).docx Supplementary Document Uploaded 2026-01-29 Available
CMS2442F_CMS10391 Supporting Statement Redline (1.20.2026) CLEAN.docx Supporting Statement A Uploaded 2026-01-29 Available

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 04/30/2026
202 202
23,898 23,898
0 0





table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 202 202 0 0 0 0
Annual Time Burden (Hours) 23,898 23,898 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No