OMB control number
Pre-Existing Condition Insurance Plan (PCIP) HIPAA Authorization Form
OMB 0938-1161 · HHS/CMS.
OMB 0938-1161
Latest Forms, Documents, and Supporting Material
Document Name |
|---|
Form and Instruction |
Justification for No Material/Nonsubstantive Change |
Form CMS-10428 PCIP Authorization Form
Justification of Non-material change.docx
PCIP Authorization Form All Historical Document Collections
|
Approved without change |
No material or nonsubstantive change to a currently approved collection | 2013-06-18 | |
|
Approved without change |
Reinstatement without change of a previously approved collection | 2013-04-05 | |
|
Approved without change |
New collection (Request for a new OMB Control Number) | 2012-03-19 |