Information Collection Request
Medicare Part C and Medicare Part D Enrollment Form Interviews (CMS-10816)
ICR 202211-0938-013 · OMB 0938-1440 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1440 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Form and Instruction |
New |
Form and Instruction |
New |
Supporting Statement A | 2022-11-29 |
Supporting Statement B | 2022-11-28 |
Supplementary Document | 2022-11-28 |
Form CMS-10816 Interview Guide
CMS-10816 - Supporting Statement A.docxIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 257119 | New | ||
| 257116 | New |
Interview GuideICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1440 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Agency Tracking No | CMC-CPC |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |