Information Collection Request
Medicare Health Plan Appeals and Grievance Data Collection and Reporting Requirements, Data Disclosure Requirements under section 422.111 (CMS-R-282)
ICR 202302-0938-004 · OMB 0938-0778 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0778 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 CMS-R-0282 - Supporting Statement_2024_30dayv508.docx |
Supporting Statement A | Uploaded 2023-02-22 | Repair queued |
| CMS Response to Comments - CMS-R-0282.docx |
Supplementary Document | Uploaded 2023-02-02 | Repair queued |
 CMS-R-0282 Crosswalk_v508.pdf |
Supplementary Document | Uploaded 2023-02-02 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 8532 |  Collecting Appeals and Grievance Data |
Instruction | Modified | |
| 46763 | Reporting Appeals and Grievance Data |
Other-Sample Report | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0778 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 201910-0938-007 |
| Agency Tracking No | CM-CPC |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |