OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Non-Quantitative Treatment Limitation Analyses and Compliance Under MHPAEA (CMS-10773)

OMB 0938-1393 · HHS/CMS.

OMB 0938-1393

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
CMS-10773 - Track Change.docxSupporting Statement A
Consumer Requests for Comparative Analyses Information collection
Recordkeeping Requirements (Issuers and Non-Federal Government) Information collection
(Issuers) - Documentation and Data Requirements for NQTL Comparative Analyses Information collection
(Self-Funded - Non-Government) Documentation and Data Requirements for NQTL Comparative Analyses Information collection
Notification of Non-compliance (Self-Insured Non-Federal Governmental Plans and Issuers) Other-Guidance
Corrective Action Plans (Self-Insured Non-Federal Governmental Plans and Issuers) Other-Guidance
Review of Comparative Analysis (Issuers and Self-Insured Non-Federal Governmental Plans) Other-Guidance
Self-Insured Non-Federal Governmental Plans (NQTL analysis) Other-Guidance
Issuers (NQTL Analysis Documentation and Recordkeeping) Other-Guidance

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202409-0938-011 Revision of a currently approved collection 2024-09-26
202110-0938-013 Extension without change of a currently approved collection 2021-10-26 Approved with change
202104-0938-001 New collection (Request for a new OMB Control Number) 2021-04-02 Approved with change