Information Collection

Administrative Requirements for Section 6071 of the DRA

IC 186838 under ICR 202609-0938-002 · OMB 0938-1053.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form CMS-10249
Semi-Annual Progress Report Administrative Requirements for Section 6071 of the DRA
Form
Form CMS-10249
MFP Financial Reporting Forms (FRFs) ABCD Administrative Requirements for Section 6071 of the DRA
Form
Form CMS-10249
MFP_Budget_Workbook Administrative Requirements for Section 6071 of the DRA
Form and Instruction
Form CMS-10249
Maintenance of Effort (MOE) Form Administrative Requirements for Section 6071 of the DRA
Form and Instruction
Form CMS-10249
Work Plan Administrative Requirements for Section 6071 of the DRA
Form
Form CMS-10249
MFP Financial Reporting Forms (FRFs) Administrative Costs: Add Sub Recipient Administrative Requirements for Section 6071 of the DRA
Form
Form CMS-10249
MFP Financial Reporting Form (FRFs) Administrative Costs: Error Administrative Requirements for Section 6071 of the DRA
Form
Form CMS-10249
MFP Financial Reporting Forms (FRFs) Demonstration Services Administrative Requirements for Section 6071 of the DRA
Form
Form CMS-10249
MFP Financial Reporting Forms (FRFs) FMAP Default Administrative Requirements for Section 6071 of the DRA
Form
Form CMS-10249
MFP Financial Reporting Forms (FRFs) FMAP Error Administrative Requirements for Section 6071 of the DRA
Form
Form CMS-10249
MFP Financial Reporting Forms (FRFs) General Information Administrative Requirements for Section 6071 of the DRA
Form
Form CMS-10398
MFP Financial Reporting Forms (FRFs) Qualified HCBS Administrative Requirements for Section 6071 of the DRA
Form
Form CMS-10249
MFP Financial Reporting Form (FRF) Supplemental Services Administrative Requirements for Section 6071 of the DRA
Form
MFP-Operational-Protocol.pdf Other-Operational Protocol
CMS-10249 Semi-Annual Progress Report
MFP_SAR - Initiative Single Page-508 Compliant.pdf
Form
CMS-10249 MFP Financial Reporting Forms (FRFs) ABCD
MFP_FRF_ABCD Totals.pdf-508 Compliant.pdf
Form
CMS-10249 MFP_Budget_Workbook
MFP-Budget-Workbook-2023.pdf
Form and Instruction
CMS-10249 Maintenance of Effort (MOE) Form
MFP_MOE_Form.pdf
Form and Instruction
CMS-10249 Work Plan
MFP_WP_Initiative Data Entry-508 Compliant.pdf
Form
CMS-10249 MFP Financial Reporting Forms (FRFs) Administrative Cost
MFP_FRF_Administrative costs_Add Sub Recipient.pdf-508 Compliant.pdf
Form
CMS-10249 MFP Financial Reporting Form (FRFs) Administrative Costs
MFP_FRF_Administrative costs_Error.pdf-508 Compliant.pdf
Form
CMS-10249 MFP Financial Reporting Forms (FRFs) Demonstration Servi
MFP_FRF_Demonstration services_default.pdf-508 Compliant.pdf
Form
CMS-10249 MFP Financial Reporting Forms (FRFs) FMAP Default
MFP_FRF_FMAP_default.pdf-508 Compliant.pdf
Form
CMS-10249 MFP Financial Reporting Forms (FRFs) FMAP Error
MFP_FRF_FMAP_Error.pdf-508 Compliant.pdf
Form
CMS-10249 MFP Financial Reporting Forms (FRFs) General Information
MFP_FRF_General info_default.pdf-508 Compliant.pdf
Form
CMS-10398 MFP Financial Reporting Forms (FRFs) Qualified HCBS
MFP_FRF_Qualified HCBS_default.pdf-508 Compliant.pdf
Form
CMS-10249 MFP Financial Reporting Form (FRF) Supplemental Services
MFP_FRF_Supplemental services_1 Other added.pdf-508 Compliant.pdf
Form
MFP ABCD Crosswalk_March 2026_to_CMS-508 Compliant.pdf
Crosswalk: MFP Financial Reporting Form
IC Document
MFP SAR Crosswalk_March 2026_to_CMS-508 Compliant.pdf
Crosswalk: MFP Semi-Annual Progress Report
IC Document
MFP Work Plan Crosswalk_March 2026_to_CMS- 508 Compliant.pdf
Crosswalk: MFP Work Plan
IC Document
MFP-OP-Crosswalk.pdf
Crosswalk: MFP Operational Protocol
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10249 Yes Yes Fillable Fileable
Form CMS-10249 Yes Yes Fillable Printable
Form and Instruction CMS-10249 Yes Yes Fillable Fileable
Form and Instruction CMS-10249 Yes Yes Fillable Fileable
Other-Operational Protocol Yes Yes Printable Only
Form CMS-10249 Yes Yes Fillable Fileable
Form CMS-10249 Yes Yes Fillable Fileable
Form CMS-10249 Yes Yes Fillable Fileable
Form CMS-10249 Yes Yes Fillable Fileable
Form CMS-10249 Yes Yes Fillable Fileable
Form CMS-10249 Yes Yes Fillable Fileable
Form CMS-10249 Yes Yes Fillable Fileable
Form CMS-10398 Yes Yes Fillable Fileable
Form CMS-10249 Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested 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 451 0 41 0 0 410
Annual IC Time Burden (Hours) 4,633 0 -370 0 0 5,003
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Crosswalk: MFP Financial Reporting Form 09/09/2026
Crosswalk: MFP Semi-Annual Progress Report 09/09/2026
Crosswalk: MFP Work Plan 09/09/2026
Crosswalk: MFP Operational Protocol 09/09/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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