OMB control number
Provider-Preventable Conditions under 42 CFR 438.6 and 447.26 and Title 2702 Non-Payment Preprint (Attachment 4.19)
OMB 0938-1136 · HHS/CMS.
OMB 0938-1136
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 CMS-10364 Supporting Statement [rev 07-06-11].doc | Supporting Statement A |
 Provider-Preventable Conditions under 42 CFR 447.26(c)(2) |
Information collection |
| Provider-Preventable Conditions under 447.26(c)(1) and Payment for Services Preprint |
Other-CMS-10364 Preprint |
| Provider-Preventable Conditions under 42 CFR 438.6(f)(2) |
Information collection |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201106-0938-002 | New collection (Request for a new OMB Control Number) | 2011-06-06 | Approved without change |