OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Medicare Part C and Medicare Part D Enrollment Form Interviews (CMS-10816)

OMB 0938-1440 · HHS/CMS.

OMB 0938-1440

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10816 Interview Guide Form and Instruction
Form CMS-10816 Invitation & Screening Form and Instruction
CMS 10816 - Non-Sub Change Request Memo for Additional Interviews.docx Justification for No Material/Nonsubstantive Change
Attachment B_CMS 10816 - Item Crosswalk.docx Supplementary Document
Responses to OMB comments 030323.docx Supplementary Document
Attachment C_CMS-10816 - Supporting Statement A_Non sub requestv2.docx Supporting Statement A
Attachment D_CMS-10816 Supporting Statement B_Non sub request.docx Supporting Statement B
CMS Response to CMS-10816 60-day Public Comments 11.14.22 Final.docx Supplementary Document
Interview Guide Form and Instruction
Invitation & Screening Form and Instruction

All Historical Document Collections

202312-0938-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-12-08
202211-0938-013 Approved with change	New collection (Request for a new OMB Control Number)	2022-11-29