OMB control number

Program Integrity and Additional State Information Collections

OMB 0938-1213 · HHS/CMS.

OMB 0938-1213

Latest Forms, Documents, and Supporting Material

Document Name
Appendix E - Part 156 Subpart I .pdf Supplementary Document
Appendix D - AV Continuance Tables.xlsm Supplementary Document
Appendix C - Habilitative Services.pdf Supplementary Document
Appendix B Data Elements for Notices Part 155 156 157 .pdf Supplementary Document
Appendix A - Agents and Brokers.pdf Supplementary Document
CMS-10490.Supporting Statement Part A.docx Supporting Statement A
45 CFR 156.1230
45 CFR 156.1210
45 CFR 156.1230
45 CFR 156.1210
45 CFR 156.1010
45 CFR 156.901-156.963
45 CFR 156.715
45 CFR 156.715
156.1230(a)(2)
156.1230(a)(1)
156.1010
156.135
155.115 - Habilitative Services
Notices
Records Storage
Notice of Appeals Actions
Forms - Appeal Withdrawal, Request to Vacate a Dismissal, Special Considerations and Appointment of Authorized Representative
Evidence Submission
Appeals
Appeals - Appeal Form
155.310(k)
155.260 - Agents and Brokers
155.260 - Certified Application Counselors
155.260 - Navigators
155.220(g)(2)
155.220(c)(4)
155.220(c)(3)(vii)

All Historical Document Collections

201309-0938-019 Approved without change	New collection (Request for a new OMB Control Number)	2013-09-17
201307-0938-016 Comment filed on proposed rule	New collection (Request for a new OMB Control Number)	2013-07-23