Information Collection

Rural Health Transformation (RHT) Program Reporting (CMS-10949)

IC 281344 under ICR 202608-0938-012 · OMB 0938-1498.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10949 RHT Program Reporting Template Rural Health Transformation (RHT) Program Reporting (CMS-10949)	Form and Instruction
Form CMS-10949 RHT Program Project Plan Template Rural Health Transformation (RHT) Program Reporting (CMS-10949)	Form and Instruction
PRA Resubmission State Reporting Expectations Guide 08.11.26.docx	Instruction
RHTP Draft Screens 06.09.2026.pdf	Other-Screen Shots
CMS-10949.Obligated and Spent Funds Reporting Guide 08.13.2026_CLEAN.pdf	Instruction
CMS-10949 RHT Program Reporting Template PRA Resubmission Final Reporting Template.xlsx	Form and Instruction
CMS-10949 RHT Program Project Plan Template PRA Project Plan Template.xlsx	Form and Instruction
CMS-10949.Obligated and Spent Funds Reporting Guide 08.13.26_REDLINE...pdf CMS-10949.Obligated and Spent Funds Reporting Guide 08.13.26_REDLINE..	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10949	Yes	Yes	Fillable Fileable
Form and Instruction	CMS-10949	Yes	Yes	Fillable Fileable
Instruction		Yes	No	Printable Only
Other-Screen Shots		Yes	Yes	Fillable Fileable
Instruction		Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	18,650	18,650
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CMS-10949.Obligated and Spent Funds Reporting Guide 08.13.26_REDLINE..		08/14/2026

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

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