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CMS-10718_Supporting Statement_A_Race_Ethnicity_June 2022 - Clean
CMS-10718_Supporting Statement_A_Race_Ethnicity_June 2022 - Clean.docx
Model Medicare Advantage and Medicare Prescription Drug Plan Individual Enrollment Request Form (CMS-10718)
OMB: 0938-1378
OMB.report
HHS/CMS
OMB 0938-1378
ICR 202306-0938-006
CMS-10718_Supporting Statement_A_Race_Ethnicity_June 2022 - Clean
( Supporting Statement A )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1378 can be found here:
2024-01-11 - Revision of a currently approved collection
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