OMB control number
Letter Requesting Waiver of Medicare/Medicaid Enrollment Application Fee; Submission of Fingerprints; Submission of Medicaid Identifying Information; Medicaid Site Visit and Rescreening (CMS-10357)
OMB 0938-1137 · HHS/CMS.
OMB 0938-1137
Latest Forms, Documents, and Supporting Material
Document Name |
|---|
Supplementary Document |
Supplementary Document |
Supporting Statement A |
CMS-10357.Transmittal 371.pdf
CMS-10357_Supporting_Statement_Part_A (11-25-14).docx
State Medicaid Agency Processing of Rescreening Application All Historical Document Collections
|
Approved with change |
Reinstatement without change of a previously approved collection | 2014-10-03 | |
|
Approved with change |
New collection (Request for a new OMB Control Number) | 2011-03-01 | |
|
Comment filed on proposed rule |
New collection (Request for a new OMB Control Number) | 2010-10-20 |