Non-substantive change request justification

Non-Substantive Change Request to 0938-1384: Submissions of 1135 Waiver Request
Automated Process
August 3, 2022
This is a non-substantive change request to the CMS 1135 Waiver/Flexibility Request from the
‘Submission of 1135 Waiver Request Automated Process’ that was approved as OMB number
0938-1384. CMS must be able to apply waivers and flexibilities to assist health care
providers/suppliers in providing timely healthcare and services as well as ensure beneficiaries
have continued access to care during a disaster or emergency. Accordingly, CMS developed a
publically-accessible web based form to create a standardized, user-friendly submission that’s a
more efficient processing of 1135 waiver requests.
Last week (July 2022), dangerous and destructive flooding occurred in the State of Kentucky.
This has negatively impacted the State. As a result, the Secretary of Health and Human Services
is in the process of review for a “Public Health Emergency” (PHE) declaration for
Kentucky. Therefore, CMS is requesting approval of the following update to allow the agency to
quickly provide necessary assistance to those impacted by these floods (effective date as defined
by the Secretary’s PHE declaration):
CMS 1135 Waiver/Flexibility Request, CMS 1135 Inquiry and CMS 1135
Waiver/Flexibility Request (MEDICAID PORTION) web pages
•

Update the Public Health Emergency (PHE) on pages 2, 5, 7, 9, 11 and 13, such that
“Kentucky Flooding” is added in the drop-down values for the “Select a Public Health
Emergency” section of the web form

These changes have no impact on the previously stated burden associated with this collection.

1