OMB control number
Healthy Indiana Program (HIP) 2.0 Beneficiary Focus Groups and Informational Interviews (CMS-10615)
OMB 0938-1300 · HHS/CMS.
OMB 0938-1300
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form CMS-10615 Informational Interviews | Form and Instruction |
| CMS-10615 - Supporting Statement A rev 04-17-18_OIRA pass CLEAN.docx | Supporting Statement A |
| 14. SupportingStatement_PartB_19July2016.docx | Supporting Statement B |
| Justification for Nonsubstantive Change_5May2017_March2018_revised_clean.docx | Justification for No Material/Nonsubstantive Change |
| SupportingMaterials_HIP 2.0FG_03.29.2018.CLEAN.docx | Supplementary Document |
 Informational Interviews |
Form and Instruction |
| Focus Groups |
Other-Telephone Recruitment Script |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201807-0938-001 | No material or nonsubstantive change to a currently approved collection | 2018-07-05 | Approved without change | |
| 201803-0938-011 | No material or nonsubstantive change to a currently approved collection | 2018-04-06 | Approved without change | |
| 201609-0938-012 | Extension without change of a currently approved collection | 2016-09-26 | Approved without change | |
| 201605-0938-003 | Revision of a currently approved collection | 2016-05-04 | Approved with change | |
| 201603-0938-017 | No material or nonsubstantive change to a currently approved collection | 2016-03-25 | Approved without change | |
| 201603-0938-014 | New collection (Request for a new OMB Control Number) | 2016-03-18 | Approved without change |