CMS-10752 Non-Substantive Change

CMS 10752 Non-Substantive Change_2023 Hurricane Idalia.docx

Submissions of 1135 Waiver Request Automated Process (CMS-10752)

CMS-10752 Non-Substantive Change

OMB: 0938-1384

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Non-Substantive Change Request to 0938-1384: Submissions of 1135 Waiver Request Automated Process

August 28, 2023

This is a non-substantive change request to the CMS 1135 Waiver/Flexibility Request from the ‘Submission of 1135 Waiver Request Automated Process’ that was approved as OMB number 0938-1384. CMS must be able to apply waivers and flexibilities to assist health care providers/suppliers in providing timely healthcare and services as well as ensure beneficiaries have continued access to care during a disaster or emergency.  Accordingly, CMS developed a publically-accessible web based form to create a standardized, user-friendly submission that’s a more efficient processing of 1135 waiver requests.

Hurricane Idalia is forecasted to possibly impact Florida, Georgia, South Carolina and North Carolina over the next several days. As a result, the Secretary of Health and Human Services may declare a “Public Health Emergency” (PHE) for this event.  Consequently, CMS is requesting approval of the following update (if applicable) to allow the agency to quickly provide necessary assistance to those impacted by this hurricane (effective date as defined by the Secretary’s PHE declaration):

CMS 1135 Waiver/Flexibility Request, CMS 1135 Inquiry and CMS 1135 Waiver/Flexibility Request (MEDICAID PORTION) web pages

  • Update the Public Health Emergency (PHE) portion, such that “2023 Hurricane Idalia” is added in the drop-down values for the “Select a Public Health Emergency” section of the web form

These changes have no impact on the previously stated burden associated with this collection.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorBen Walker
File Modified0000-00-00
File Created2024-07-20

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