OMB control number

Program Integrity and Additional State Information Collections

OMB 0938-1213 · HHS/CMS.

OMB 0938-1213

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Appendix E - Part 156 Subpart I .pdf	Supplementary Document
Appendix D - AV Continuance Tables.xlsm	Supplementary Document
Appendix C - Habilitative Services.pdf	Supplementary Document
Appendix B Data Elements for Notices Part 155 156 157 .pdf	Supplementary Document
Appendix A - Agents and Brokers.pdf	Supplementary Document
CMS-10490.Supporting Statement Part A.docx	Supporting Statement A
45 CFR 156.1230	Information collection
45 CFR 156.1210	Information collection
45 CFR 156.1230	Information collection
45 CFR 156.1210	Information collection
45 CFR 156.1010	Information collection
45 CFR 156.901-156.963	Information collection
45 CFR 156.715	Information collection
45 CFR 156.715	Information collection
156.1230(a)(2)	Information collection
156.1230(a)(1)	Information collection
156.1010	Information collection
156.135	Information collection
155.115 - Habilitative Services	Information collection
Notices	Information collection
Records Storage	Information collection
Notice of Appeals Actions	Information collection
Forms - Appeal Withdrawal, Request to Vacate a Dismissal, Special Considerations and Appointment of Authorized Representative	Information collection
Evidence Submission	Information collection
Appeals	Information collection
Appeals - Appeal Form	Information collection
155.310(k)	Information collection
155.260 - Agents and Brokers	Information collection
155.260 - Certified Application Counselors	Information collection
155.260 - Navigators	Information collection
155.220(g)(2)	Information collection
155.220(c)(4)	Information collection
155.220(c)(3)(vii)	Information collection

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
201309-0938-019	New collection (Request for a new OMB Control Number)	2013-09-17		Approved without change
201307-0938-016	New collection (Request for a new OMB Control Number)	2013-07-23		Comment filed on proposed rule