Suppliers that Choose Not to Grandfather - Round 2 (30-Day Notification to Beneficiary)

Grandfathering Provisions of the Medicare DMEPOS Competitive Bidding Program

OMB: 0938-1079

IC ID: 207248

Documents and Forms
Information Collection (IC) Details

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Suppliers that Choose Not to Grandfather - Round 2 (30-Day Notification to Beneficiary)
 
No Removed
 
Mandatory
 
42 CFR 414.408(j)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Sample Letter Sample Letter to Beneficiary from Supplier that Chooses NOT to Grandfather CLEAN 508.pdf No No Fillable Printable

Health Health Care Services

 

694 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 -57,833 0 0 57,833
Annual IC Time Burden (Hours) 0 0 -4,858 0 0 4,858
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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