OMB control number
Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services (CMS-10344)
OMB 0938-1127 · HHS/CMS.
OMB 0938-1127
This provision is mandated by the Affordable Care Act, section 3309. To implement this provision, CMS needs data from the States, identifying full benefit dual-eligible individuals who are receiving home and community-based services. The States will provide these data as a new data value on their monthly MMA Phase Down report. These data are not available from any other source. CMS will use these new data to set the affected beneficiaries' Medicare Part D copayment to zero.
The latest form for Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services (CMS-10344) expires 2026-09-30 and is listed under ICR 202304-0938-009.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 CMS-10344 - Supporting Statement_A.docx | Supporting Statement A |
 Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services (Annual - effective 1/1/2012) |
Information collection |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202602-0938-014 | Extension without change of a currently approved collection | 2026-02-18 | ||
| 202304-0938-009 | Revision of a currently approved collection | 2023-04-19 | Approved without change | |
| 201912-0938-008 | Extension without change of a currently approved collection | 2019-12-11 | Approved with change | |
| 201702-0938-008 | Extension without change of a currently approved collection | 2017-02-23 | Approved with change | |
| 201401-0938-001 | Extension without change of a currently approved collection | 2014-01-02 | Approved without change | |
| 201101-0938-003 | New collection (Request for a new OMB Control Number) | 2011-01-05 | Approved with change |