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

Latest forms, documents, and information collections
Document	Type
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All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
201204-0990-004	New collection (Request for a new OMB Control Number)	2012-04-30		Approved with change