Implementation of the Military Health System Modified Payment and Waiver Program

ICR 202308-0720-001

OMB:

Federal Form Document

Forms and Documents

Document Name	Status
0720-HFSA_SSA_9.27.2024.docx Supporting Statement A	2024-09-27
Disapproval Memo script.docx Supplementary Document	2024-05-09
SSNJ_DDFormx3201_07.13.2023.pdf Supplementary Document	2023-09-13

IC Document Collections

IC ID	Document Title	Status
264328	Request for Medical Debt Waiver, Military Health System Modified Payment and Waiver Program Form and Instruction	New
262159	Application for Military Health System Modified Payment and Waiver Program Form	New