Information Collection Request

[Medicaid] Rural Health Transformation (RHT) Program Reporting

ICR 202607-0938-002 · OMB 0938-1498 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10949 RHT Program Project Plan Template Form and Instruction New Missing upstream
Form CMS-10949 RHT Program Project Plan Template Form and Instruction New Available
Form CMS-10949 RHT Program Reporting Template Form and Instruction New Repair queued
Form CMS-10949 RHT Program Reporting Template Form and Instruction New Available
RHTP_CMS PRA 30 Day Comment Responses_08.11.2026.docx Supplementary Document Uploaded 2026-08-13 Repair queued
FAH RHTF PRA CommentsFINAL08052026.pdf Public Comments Uploaded 2026-08-05 Repair queued
CMS 10949 Reporting Template (RHTP) - DHS Public Comment.pdf Public Comments Uploaded 2026-08-05 Repair queued
PRA JUL RHTP Comments_vF.pdf Public Comments Uploaded 2026-08-05 Repair queued
RHTP comments Form Number CMS-10949.pdf Public Comments Uploaded 2026-08-04 Repair queued
PC_202607-0938-002_080426_053355_1.pdf Public Comments Uploaded 2026-08-04 Repair queued
RHTP Reporting Requirements - NARHC.pdf Public Comments Uploaded 2026-08-04 Repair queued
Final 8_3_26 HCPF RHTP Reporting Comment Letter.pdf Public Comments Uploaded 2026-08-03 Repair queued
PC_202607-0938-002_080326_031100_1.pdf Public Comments Uploaded 2026-08-03 Repair queued
IRC Notice Comment July 2026.pdf Public Comments Uploaded 2026-07-27 Repair queued
CMS_RHTPFINAL.pdf Public Comments Uploaded 2026-07-24 Repair queued
PC_202607-0938-002_070726_074715_1.pdf Public Comments Uploaded 2026-07-07 Repair queued
Public Comments (Bulk).pdf Public Comments Uploaded 2026-05-20 Available
RHTP_CMS PRA Comment Responses_06.09.2026_final_clean.docx Supplementary Document Uploaded 2026-07-06 Repair queued
RHTP_CMS PRA Comment Responses_06.09.2026_final_clean.docx Supplementary Document Uploaded 2026-07-06 Available
CMS-10949 - Supporting Statement A (2026 version 9).docx Supporting Statement A Uploaded 2026-08-13 Repair queued
CMS-10949 - Supporting Statement A (2026 version 6).docx Supporting Statement A Uploaded 2026-07-06 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
281344 Rural Health Transformation (RHT) Program Reporting (CMS-10949) Form and Instruction NewRHT Program Project Plan Template
281344 Rural Health Transformation (RHT) Program Reporting Form and Instruction NewRHT Program Project Plan Template
281344 Rural Health Transformation (RHT) Program Reporting (CMS-10949) Form and Instruction NewRHT Program Reporting Template
281344 Rural Health Transformation (RHT) Program Reporting Form and Instruction NewRHT Program Reporting Template
281344 Rural Health Transformation (RHT) Program Reporting (CMS-10949) Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2029 36 Months From Approved
200 0 0
18,650 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Rural Health Transformation (RHT) Program Reporting (CMS-10949) CMS-10949, CMS-10949 ,  

table that charts list of burden
  Total Approved 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 200 0 200 0 0 0
Annual Time Burden (Hours) 18,650 0 18,650 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No