Information Collection Request
Provider Network Coverage Data Collection (CMS-10594)
ICR 202301-0938-014 · OMB 0938-1302 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1302 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 CMS-10594 Network Adequacy_Supporting 11923.docx |
Supporting Statement A | Uploaded 2023-01-20 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 219312 |  Provider Network Coverage - Notice to Enrollees |
Modified | ||
| 219311 | Provider Network Coverage - Provider Discontinuation |
Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1302 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 201908-0938-012 |
| Agency Tracking No | CCIIO |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |