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Medicare Disproportionate Share Adjustment Procedures and Criteria and Supporting Regulations in 42 CFR 412.106
Medicare Disproportionate Share Adjustment Procedures and Criteria and Supporting Regulations in 42 CFR 412.106
OMB: 0938-0691
IC ID: 43662
OMB.report
HHS/CMS
OMB 0938-0691
ICR 200606-0938-003
IC 43662
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0691 can be found here:
2018-10-05 - Reinstatement without change of a previously approved collection
2014-01-10 - Reinstatement without change of a previously approved collection
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IC Title:
Medicare Disproportionate Share Adjustment Procedures and Criteria and Supporting Regulations in 42 CFR 412.106
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Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Required to Obtain or Retain Benefits
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Available Electronically?
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Electronic Capability
Form
R-194
No
No
Federal Enterprise Architecture Business Reference Module
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Privacy Act System of Records
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Number of Respondents:
100
Number of Respondents for Small Entity:
0
Affected Public:
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0 %
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0
0
100
Annual IC Time Burden (Hours)
100
0
0
0
0
100
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0
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0
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0
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