Information Collection Request
Reporting Requirements Regarding Air Ambulance Services (CMS-10785)
ICR 202108-0938-013 · OMB unassigned · Historical Inactive
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 CMS-10785 Air Ambulance Reporting Supporting Statement frc.docx |
Supporting Statement A | Uploaded 2021-09-16 | Available |
| CMS-10785 Air Ambulance Reporting Supporting Statement frc.docx |
Supporting Statement A | Uploaded 2021-09-16 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 249056 |  Title: Reporting Requirements Regarding Air Ambulance Services – Providers of Air Ambulance Services |
Instruction | New | |
| 249054 | Reporting Requirements Regarding Air Ambulance Services – Plans, Issuers, and FEHB carriers |
Instruction | New |
ICR Details
| Status | Historical Inactive |
|---|---|
| Agency/Subagency | HHS/CMS |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Agency Tracking No | CCIIO-10785 |
| Date Submitted to OIRA | 2021-09-16 |
| Requested Expiration Date | 1969-12-31 |