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

ICR 202306-0938-001

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1384 can be found here:

Forms and Documents

Document Name	Status
Form CMS-10752 Acute Hospital Care at Home Form and Instruction	Unchanged
Form CMS-10752 1135 Waiver Request Automated Process Form and Instruction	Modified
CMS 10752 Non-Substantive Change_2023 Typhoon Mawar_May.docx Justification for No Material/Nonsubstantive Change	2023-06-01
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
243968	1135 Waiver Request Automated Process Form and Instruction	Modified

ICR Details