Information Collection Request
Evaluating Coverage to Care in Communities (CMS-10632)
ICR 202301-0938-018 · OMB 0938-1342 · Active
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10632 Consumer Survey |
Form and Instruction | Unchanged | Available |
| Form CMS-10632 Consumer Survey |
Form and Instruction | Unchanged | Repair queued |
| Form CMS-10632 Partner Survey |
Form and Instruction | Unchanged | Available |
| Form CMS-10632 Partner Survey |
Form and Instruction | Unchanged | Repair queued |
 CMS-10632_Non-sub_Change_Request_Memo 012623.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2023-01-26 | Available |
| CMS-10632_Non-sub_Change_Request_Memo 012623.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2023-01-26 | Repair queued |
| CMS-10632_Supporting_Statement_B_clean_srs_012523.docx |
Supporting Statement B | Uploaded 2023-01-26 | Available |
| CMS-10632_Supporting_Statement_B_clean_srs_012523.docx |
Supporting Statement B | Uploaded 2023-01-26 | Missing upstream |
| CMS-10632_OMH_Supporting_Statement_A_clean_srs_012523.docx |
Supporting Statement A | Uploaded 2023-01-26 | Available |
| CMS-10632_OMH_Supporting_Statement_A_clean_srs_012523.docx |
Supporting Statement A | Uploaded 2023-01-26 | Repair queued |
 CMS-10632.Appendix_E_Survey_Changes_srs_022221.pdf |
Supplementary Document | Uploaded 2021-05-06 | Available |
| CMS-10632.Appendix_E_Survey_Changes_srs_022221.pdf |
Supplementary Document | Uploaded 2021-05-06 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 226369 |  Consumer Survey |
Form and Instruction | Unchanged | |
| 226369 | Consumer Survey |
Form and Instruction | Unchanged | |
| 226367 | Partner Survey |
Form and Instruction | Unchanged | |
| 226367 | Partner Survey |
Form and Instruction | Unchanged |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1342 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202105-0938-002 |
| Agency Tracking No | OMH |
| Date Submitted to OIRA | 2023-02-02 |
| Requested Expiration Date | 1969-12-31 |