Information Collection Request
Proposed Prior Authorization Process and Requirements for Certain Hospital Outpatient Department (OPD) Services (CMS-10711)
ICR 202405-0938-022 · OMB 0938-1368 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1368 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 CMS Responses CMS-10711 (60-days).docx |
Supplementary Document | Uploaded 2024-05-22 | Repair queued |
 CMS-10711.Supporting Statement Part Af.pdf |
Supporting Statement A | Uploaded 2024-05-21 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 254983 |  Prior Authorization Process (Facet Joint Interventions) |
Modified | ||
| 237862 | Prior Authorization Process (Five Original Categories) |
Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1368 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202212-0938-002 |
| Agency Tracking No | CPI |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |