Information Collection Request

[Medicaid] Rural Health Transformation (RHT) Program Reporting (CMS-10949)

ICR 202608-0938-012 · OMB 0938-1498 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10949 RHT Program Project Plan Template Form and Instruction Modified Available
Form CMS-10949 RHT Program Reporting Template Form and Instruction Modified Available
CMS-10949 (0938-1498) RHTP Justification of Non-substantive change memo (final 8-14-26 @218pm).docx Justification for No Material/Nonsubstantive Change Uploaded 2026-08-14 Available
RHTP_CMS PRA 30 Day Comment Responses_08.11.2026.docx Supplementary Document Uploaded 2026-08-13 Available
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 Available

IC Document Collections

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

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2029 08/31/2029 08/31/2029
200 0 200
18,650 0 18,650
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 200 200 0 0 0 0
Annual Time Burden (Hours) 18,650 18,650 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No