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CMS-10615 HIP 2.0 Disenrollee and Lockout Beneficiary Survey (web
Healthy Indiana Program (HIP) 2.0 Beneficiaries Survey, Focus Groups, and Informational Interviews (CMS-10615)
6. Disenrollee Web Survey v.2 0720 NoExpDate
Beneficiaries Survey
OMB: 0938-1300
OMB.report
HHS/CMS
OMB 0938-1300
ICR 201605-0938-003
IC 220696
CMS-10615 HIP 2.0 Disenrollee and Lockout Beneficiary Survey (web
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1300 can be found here:
2018-07-05 - No material or nonsubstantive change to a currently approved collection
2018-04-06 - No material or nonsubstantive change to a currently approved collection
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Page Disenrollee Web Survey
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application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author
David Bryant
File Modified
0000-00-00
File Created
2021-01-23
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