Crosswalk (30-day)

SMAC PRA instrument Crosswalk - 30-Day Notice .docx

Dual Eligible Special Needs Plan Contract with the State Medicaid Agency (CMS-10796)

Crosswalk (30-day)

OMB: 0938-1410

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CMS-10796 Collection Instrument Change Crosswalk: Changes to D-SNP State Medicaid Agency(ies) Contract(s)

Changes between 60-day notice period and 30-day notice period

Appendix A: Attestations

Location of Change

Description of Change

Reason for Change

Effect on Burden

Attestation #4

Modified language from “before the SMAC submission deadline” to “by the SMAC submission deadline”

Amended language aligns with current policy that the SMAC matrix is to be submitted by the deadline.

None



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorKlotz, Sara (CMS/FCHCO)
File Modified0000-00-00
File Created2025-05-19

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