Information Collection

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

IC 281344 under ICR 202610-0938-011 · 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 10.20.26.docx	Instruction
PRA Resubmission Obligated and Spent Funds Reporting Guide 10.20.26.docx	Instruction
CMS-10949 RHT Program Reporting Template Budget Period 1 Financial Reporting Template.xlsx	Form and Instruction
CMS-10949 RHT Program Project Plan Template PRA Project Plan Template.xlsx	Form and Instruction
PRA Resubmission State Reporting Expectations Guide 10.20.26_Redline.docx REDLINE: Reporting Expectations Guide	IC Document
PRA Resubmission Obligated and Spent Funds Reporting Guide 10.20.26_Redline.docx REDLINE: Obligated and Spent Funds Reporting Guide	IC Document
Budget Period 1 Financial Reporting Template - Redline.xlsx REDLINE: Template	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
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
	Requested	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
REDLINE: Reporting Expectations Guide		10/27/2026
REDLINE: Obligated and Spent Funds Reporting Guide		10/27/2026
REDLINE: Template		10/27/2026

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].