OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Adapting Best Practices for Medicaid Readmissions

OMB 0935-0204 · HHS/AHRQ.

OMB 0935-0204

Latest Forms, Documents, and Supporting Material

Document Name
Form Form #5 Provider interviews Form and Instruction
Form Form #3 Patient/family /caregiver interviews Form and Instruction
Form Form #1 Medical records review Form and Instruction
Supporting Statement Part B -- Adopting Best Practices for Medicaid Readmissions 11-26-2012.doc Supporting Statement B
Attachment G -- Federal Register Notice.pdf Supplementary Document
Supporting Statement Part A -- Adopting Best Practices for Medicaid Readmissions 11-26-2012.doc Supporting Statement A
Provider interviews Form and Instruction
Patient/family /caregiver interviews Form and Instruction
Medical records review Form and Instruction

All Historical Document Collections

201206-0935-001

Approved with change

New collection (Request for a new OMB Control Number)

2012-06-18