Medicare Part C and Medicare Part D Enrollment Form Interviews (CMS-10816)

ICR 202211-0938-013

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1440 can be found here:

Forms and Documents

Document Name	Status
Form CMS-10816 Interview Guide Form and Instruction	New
Form CMS-10816 Invitation & Screening Form and Instruction	New
CMS-10816 - Supporting Statement A.docx Supporting Statement A	2022-11-29
CMS-10816 - Supporting Statement B.docx Supporting Statement B	2022-11-28
CMS Response to CMS-10816 60-day Public Comments 11.14.22 Final.docx Supplementary Document	2022-11-28

IC Document Collections

IC ID	Document Title	Status
257119	Interview Guide Form and Instruction	New
257116	Invitation & Screening Form and Instruction	New

ICR Details