CMS-10752 Non-Substantive Change

CMS 10752 Non-Substantive Change_Destructive Storms and Tornadoes_Mar.docx

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

CMS-10752 Non-Substantive Change

OMB: 0938-1384

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Non-Substantive Change Request to 0938-1384: Submissions of 1135 Waiver Request Automated Process

March 26, 2023



This is a non-substantive change request to the CMS 1135 Waiver/Flexibility Request from the ‘Submission of 1135 Waiver Request Automated Process’ that was approved as OMB number 0938-1384. CMS must be able to apply waivers and flexibilities to assist health care providers/suppliers in providing timely healthcare and services as well as ensure beneficiaries have continued access to care during a disaster or emergency.  Accordingly, CMS developed a publically-accessible web based form to create a standardized, user-friendly submission that’s a more efficient processing of 1135 waiver requests.


This past weekend, destructive storms and tornadoes occurred in the US Southern States (the worst damage occurred in the State of Mississippi). As a result, the Secretary of Health and Human Services is in the process of reviewing the events to determine the need for a “Public Health Emergency” (PHE) declaration for these destructive storms and tornadoes.  Therefore, CMS is requesting approval of the following update to allow the agency to quickly provide necessary assistance to those impacted by these storms/tornadoes (effective date as defined by the Secretary’s PHE declaration):


CMS 1135 Waiver/Flexibility Request, CMS 1135 Inquiry and CMS 1135 Waiver/Flexibility Request (MEDICAID PORTION) web pages


  • Update the Public Health Emergency (PHE) portion, such that “2023 Destructive Storms and Tornadoes_Mar.” is added in the drop-down values for the “Select a Public Health Emergency” section of the web form



These changes have no impact on the previously stated burden associated with this collection.



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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorBen Walker
File Modified0000-00-00
File Created2023-07-30

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