Summary of Changes

Coverage of Certain Preventive Services Under the Affordable Care Act
(CMS-10653/OMB Control Number: 0938-1344)
Summary of Changes
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Revised certification and model notice to HHS to reflect the fact that they can be used
under whichever accommodation rules are in effect (for example, the 2017 interim final
rules, or the 2015 final rules if the 2017 interim final rules continue to be enjoined).
Revised supporting statement to include burden under the 2015 final rules as well as the
2017 interim final rules.