Essential Community Provider-Network Adequacy (ECP/NA) Data Collection to Support QHP Certification (CMS-10803)

ICR 202403-0938-012

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1415 can be found here:

Forms and Documents

Document Name	Status
Form CMS-10803 Essential Community Provider and Network Adequacy Data Requirements Form and Instruction	Modified
C_ECP-NA 60-Day Comment Response_508.pdf Supplementary Document	2022-06-07
CMS-10803_ECP-NA_Supporting Statement_03.23.24.docx Supporting Statement A	2024-03-23

IC Document Collections

IC ID	Document Title	Status
266278	QHP Issuers for the Appointment Wait Time Secret Shopper Data Collection	New
251109	Essential Community Provider and Network Adequacy Data Requirements Form and Instruction	Modified

ICR Details