Form CMS-10752 Waiver Inquiry Form
Submissions of 1135 Waiver Request Automated Process (CMS-10752)
CMS 10752 NEW 1135 Waiver-Inquiry Collection Instrument (End of COVID-19 PHE)
1135 Waiver Request Automated Process
OMB: 0938-1384
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1384 can be found here:
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