Non-substantive change request justification

Non-Substantive Change Request to 0938-1384: Submissions of 1135 Waiver Request
Automated Process
September 27, 2021
This is a non-substantive change request to the CMS 1135 Waiver/Flexibility Request and CMS
1135 Inquiry web pages from the ‘Submission of 1135 Waiver Request Automated Process’ that
was approved as OMB number 0938-1384. We found typographical errors in our PII and PHI
information on the web form. These minor corrections will not cause any changes in burden. The
changes are as follows:
CMS 1135 Waiver/Flexibility Request web page
• Correct an error on page 2, such that “Publically” Identifiable Information (PII) is now
“Personally” Identifiable Information (PII) located after section 4 (Submit Your Request)
of the web form.
• Correct an error on page 2, such that “Public” Health Information (PHI) is now
“Protected” Health Information (PHI) located after section 4 (Submit Your Request) of
the web form.
CMS 1135 Inquiry web page
• Correct an error on pages 5 and 7, such that “Publicly” Identifiable Information (PII) is
now “Personally” Identifiable Information (PII) located after section 4 (Submit Your
Request) of the web form.
• Correct an error on pages 5 and 7, such that “Public” Health Information (PHI) is now
“Protected” Health Information (PHI) located after section 4 (Submit Your Request) of
the web form.
These changes have no impact on the previously stated burden associated with this collection,
which assumed that the errors listed would not exist.