Information Collection Request
Data Collection to Support Eligibility Determinations for Insurance Affordability Programs and Enrollment through Health Benefits Exchanges, Medicaid and CHIP Agencies (CMS-10440)
ICR 202304-0938-028 · OMB 0938-1191 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1191 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 CMS-10440 Supporting Statement.60 Day_DACAf.docx |
Supporting Statement A | Uploaded 2023-04-28 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 205692 |  Individual Application |
Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1191 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202208-0938-007 |
| Agency Tracking No | CCIIO |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |