Information Collection Request
Emergency Ambulance Transports and Beneficiary Signature Requirements in 42 CFR 424.36(b) (CMS-10242)
ICR 202304-0938-006 · OMB 0938-1049 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1049 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Response to Public Comments Ambulance PRA.docx |
Supplementary Document | Uploaded 2023-04-12 | Repair queued |
| CMS-10242 Supporting Statement A.docx |
Supporting Statement A | Uploaded 2023-04-12 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 184092 |  Emergency Ambulance Transports and Beneficiary Signature Requirements in 42 CFR 424.36(b) |
Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1049 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202003-0938-001 |
| Agency Tracking No | CM-FFS |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |