Information Collection Request

Applicable Integrated Plan Coverage Decision Letter (CMS-10716)

ICR 202306-0938-003 · OMB 0938-1386 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
CMS-10716_SupportingStatement_A.docx Supporting Statement A Uploaded 2023-06-06 Repair queued
Crosswalk of Changes to CDL.pdf Supplementary Document Uploaded 2023-06-06 Repair queued
Summary of comments and responses.pdf Supplementary Document Uploaded 2023-06-05 Repair queued
Crosswalk of Changes to CDL.pdf Supplementary Document Uploaded 2023-06-05 Missing upstream
IC Document Collections
IC IDCollectionTypeStatusForm
241332 Applicable Integrated Plan Coverage Decision Letter Instruction Modified
ICR Details
StatusReceived in OIRA
Agency/SubagencyHHS/CMS
OMB Control No0938-1386
Type of Information CollectionRevision of a currently approved collection
Previous ICR Reference No202004-0938-003
Agency Tracking NoCM-CPC
Date Submitted to OIRA1969-12-31
Requested Expiration Date1969-12-31