Applicable Integrated Plan Coverage Decision Letter (CMS-10716)
ICR 202306-0938-003
OMB: 0938-1386
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1386 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Supporting Statement A | 2023-06-06 |
Supplementary Document | 2023-06-06 |
Supplementary Document | 2023-06-05 |
Supplementary Document | 2023-06-05 |
CMS-10716_SupportingStatement_A.docx
Crosswalk of Changes to CDL.pdfIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 241332 | Modified |
Applicable Integrated Plan Coverage Decision LetterICR Details
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