Certified Counselor Designated Organization (CDO Application)

Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel - CAC (CMS-10494)

OMB: 0938-1205

IC ID: 241050

Information Collection (IC) Details

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Certified Counselor Designated Organization (CDO Application)
 
No New
 
Required to Obtain or Retain Benefits
 
45 CFR 155225(b)(1)(iii)  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10494 CDO Agreement CMS-10494 - Appendix B_CMS-CDO Agreement.pdf Yes Yes Fillable Fileable
Instruction CMS-10494 - Appendix G_CDO-CAC Model Agreement.pdf Yes No Printable Only

Health Health Care Services

 

7,000 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested 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 7,000 7,000 0 0 0 0
Annual IC Time Burden (Hours) 1,225 1,225 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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