OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Federal Funding of Emergency Health Services (Section 1011); Provider Payment Determination and On-Call Cost Forms

OMB 0938-0952 · HHS/CMS.

OMB 0938-0952

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CMS-10130 Federal Funding of Emergency Health Services (Section 1011) Provider Payment Determination (CMS-10130A)Form and Instruction
Form CMS-10130 Federal Funding of Emergency Health Services;Request for Section 1011 Hospital On-call Payments to Physicians (CMS-10130B)Form and Instruction
CMS 10130 - Supporting_Statement_Part A [rev 7-19-2013 by OSORA PRA].docSupporting Statement A
Federal Funding of Emergency Health Services (Section 1011) Provider Payment Determination (CMS-10130A) Form and Instruction
Federal Funding of Emergency Health Services;Request for Section 1011 Hospital On-call Payments to Physicians (CMS-10130B) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201307-0938-008 Reinstatement without change of a previously approved collection 2013-07-19 Approved without change
200811-0938-003 Extension without change of a currently approved collection 2008-11-04 Approved without change
200511-0938-007 Extension without change of a currently approved collection 2005-11-18 Approved without change
200505-0938-003 New collection (Request for a new OMB Control Number) 2005-05-05 Approved with change