Submissions of 1135 Waiver Request Automated Process (CMS-10752)

ICR 202303-0938-012

OMB: 0938-1384

Federal Form Document

Forms and Documents

Document Name	Status
Form CMS-10752 Acute Hospital Care at Home Form and Instruction	Unchanged
Form CMS-10752 Acute Hospital Care at Home Form and Instruction	Unchanged
Form CMS-10752 1135 Waiver Request Automated Process Form and Instruction	Modified
Form CMS-10752 1135 Waiver Request Automated Process Form and Instruction	Modified
CMS 10752 Non-Substantive Change_Destructive Storms and Tornadoes_Mar.docx Justification for No Material/Nonsubstantive Change	2023-03-27
CMS 10752 Non-Substantive Change_Destructive Storms and Tornadoes_Mar.docx Justification for No Material/Nonsubstantive Change	2023-03-27
CMS 10752 Supporting Statement final 2-19-21.docx Supporting Statement A	2021-02-19
CMS 10752 Supporting Statement final 2-19-21.docx Supporting Statement A	2021-02-19

IC Document Collections

IC ID	Document Title	Status
245795	Acute Hospital Care at Home Form and Instruction	Unchanged
245795	Acute Hospital Care at Home Form and Instruction	Unchanged
243968	1135 Waiver Request Automated Process Form and Instruction	Modified
243968	1135 Waiver Request Automated Process Form and Instruction	Modified