Applicable Integrated Plan Coverage Decision Letter (CMS-10716)

ICR 202404-0938-023

OMB: 0938-1386

Federal Form Document

Forms and Documents

Document Name	Status
CMS-10716_SupportingStatement_A.docx Supporting Statement A	2023-06-06
0938-1386 (CMS 10716) - Non Substantive Change Request Memo.docx Justification for No Material/Nonsubstantive Change	2024-04-27
Summary of comments and responses.pdf Supplementary Document	2023-06-05
Crosswalk of Changes to CDL.docx Supplementary Document	2024-04-26

IC Document Collections

IC ID	Document Title	Status
241332	Applicable Integrated Plan Coverage Decision Letter Instruction	Modified