OMB control number

CHIPRA-Children's Health Insurance Program Reauthorization Act of 2009 -ELE

OMB 0990-0400 · HHS/HHSDM.

OMB 0990-0400

Latest Forms, Documents, and Supporting Material

Document Name
ATTACHMENT A_CHIPRA ELE Legislation.docx Supplementary Document
ATTACHMENT F.2. 51 state survey recruiting email text.docx Supplementary Document
ATTACHMENT I_CHIPRA ELE_30dayFR Comments Placeholder.doc Supplementary Document
ATTACHMENT L_Contractor Confidentiality Pledge.pdf Supplementary Document
Attachment H 60 Day FRN Notice Published 2 2 2012.pdf Supplementary Document
14. ATTACHMENT N.2. Pretest report on quarterly calls.docx Supplementary Document
13. ATTACHMENT N.1 Pretest memo on 51 State Survey.docx Supplementary Document
12. NEW ATTACHMENT O. CHIPRA Express Lane Eligibility Evaluation Full Approval Letter.pdf Supplementary Document
11. ATTACHMENT M_CHIPRA ELE Evaluation Final Design and Work Plan Part 1.docx Supplementary Document
10. ATTACHMENT J_TAG members.docx Supplementary Document
9 REVISED ATTACHMENT K 4_Comments.doc Supplementary Document
8 REVISED ATTACHMENT K 3_Comments.doc Supplementary Document
7 REVISED ATTACHMENT K 2_Comments.doc Supplementary Document
6 REVISED ATTACHMENT K 1_COMMENTS.doc Supplementary Document
0990-CHIPRA_ELE_Study_Part_B_Statement__FINAL_8_6_12.docx Supporting Statement B
0990-_CHIPRA_ELE_Study_Part_A_Statement_Final_8.6.12.docx Supporting Statement A
Key Informants (Quarterly Monitoring Calls) Other-interview
Medicaid and CHIP Officials Other-ATTACHMENT F.1.SCREEN SHOTS.HMA. 51 state survey form Q 8
Moderator"s Guide Other-REVISED.ATTACHMENT E1_ELE Focus Group Moderator Guide and
Local - Level Key Informant (ELE) Other-study
State - Level Key Informants- ELE States Other-study
Staff for Enrollment Data Collection Other-REVISED ATTACHMENT C ENROLLMENT EXTRACTION FORM IN EXCEL
Staff for Administrative Cost Data Collection Other-survey

All Historical Document Collections

201204-0990-004

Approved with change

New collection (Request for a new OMB Control Number)

2012-04-30