OMB control number

Medicaid Program; Medicaid State Plan Preprint for Use by States When Implementing Section 6401, Provider Screening and Other Enrollment Requirements Under Medicare, Medicaid and CHIP

OMB 0938-1151 · HHS/CMS.

OMB 0938-1151

Latest forms, documents, and information collections
Document	Type
Form CMS-10402 Medicaid State Plan Preprint for Use by States When Implementing Section 6401, the Provider Screening and Other Enrollment Requirements Under Medicare, Medicaid and CHIP	Form
CMS-10402 - Supporting Statement part A [rev 10-07-11].doc	Supporting Statement A
Medicaid State Plan Preprint for Use by States When Implementing Section 6401, the Provider Screening and Other Enrollment Requirements Under Medicare, Medicaid and CHIP	Form

Historical document collections
Reference	Filing	Received	Concluded	Action
201110-0938-004	New collection (Request for a new OMB Control Number)	2011-10-12		Approved with change