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Rebate Reduction Request Form
Rebate Reduction Requests underSections 11101 and 11102 of the Inflation Reduction Act (CMS-10858) - IRA
OMB: 0938-1474
IC ID: 268246
OMB.report
HHS/CMS
OMB 0938-1474
ICR 202407-0938-012
IC 268246
( )
Documents and Forms
Document Name
Document Type
Form CMS-10858
Rebate Reduction Request Form
Form and Instruction
CMS-10858 Appendix A and BSevere Supply Chain Disruption forms
Final clean Appendix A and B_Severe Supply Chain Disruption forms.docx
Form and Instruction
CMS-10858 Appendix C and D Likely to be in Shortage forms
Final clean Appendix C and D_Likely to be in Shortage forms.docx
Form and Instruction
508_Final redline 30 day notice Appendix A and B_Severe Supply Chain Disruption forms (compared to 60-day).docx
Redline Appendix A and B
IC Document
508_Final redline 30 day notice Appendix C and D_Likely to be in Shortage forms (compared to 60-day).docx
Redline Appendix C and D
IC Document
Information Collection (IC) Details
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