Change Request Memo

CMS-10791 - Change Request.docx

Requirements Related to Surprise Billing; Part II (CMS-10791)

Change Request Memo

OMB: 0938-1433

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CMS-10791 – Non-Substantive Change Request

The Agency inadvertently submitted an incorrect version of the Good Faith Estimates Template and Instruction document. This request is for OMB review and approval of the newly approved and updated the Good Faith Estimates Template Standard Form and Instruction with the inclusion Abbreviated Good Faith Estimate (GFE) for No-Cost Health Care Items or Services.

This change request does not result in any burden change.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorJAMAA HILL
File Modified0000-00-00
File Created2023-08-27

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