Acute Hospital Care at Home

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

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form CMS-10752 Acute Hospital Care at Home Form and Instruction
CMS-10752 Acute Hospital at Home Acute Hospital Care at Home Screenshots.docx Form and Instruction

Information Collection (IC) Details