Information Collection Request
Applicable Integrated Plan Coverage Decision Letter (CMS-10716)
ICR 202404-0938-023 · OMB 0938-1386 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1386 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 CMS-10716_SupportingStatement_A.docx |
Supporting Statement A | Uploaded 2023-06-06 | Repair queued |
| 0938-1386 (CMS 10716) - Non Substantive Change Request Memo.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2024-04-27 | Repair queued |
 Summary of comments and responses.pdf |
Supplementary Document | Uploaded 2023-06-05 | Repair queued |
| Crosswalk of Changes to CDL.docx |
Supplementary Document | Uploaded 2024-04-26 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 241332 |  Applicable Integrated Plan Coverage Decision Letter |
Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1386 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202306-0938-003 |
| Agency Tracking No | CM-CPC |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |