Information Collection Request

Evaluating Coverage to Care in Communities (CMS-10632)

ICR 202301-0938-018 · OMB 0938-1342 · Active

Forms and Documents
DocumentTypeStatusAvailability
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 Repair queued
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 IDCollectionTypeStatusForm
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
StatusActive
Agency/SubagencyHHS/CMS
OMB Control No0938-1342
Type of Information CollectionNo material or nonsubstantive change to a currently approved collection
Previous ICR Reference No202105-0938-002
Agency Tracking NoOMH
Date Submitted to OIRA2023-02-02
Requested Expiration Date1969-12-31