Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Advance Beneficiary Notice of Noncoverage (ABN) and Supporting Regulations in 42 CFR 411.404 and 411.408 Modified 63601300 7420364 0 Form CMS-R-131 Spanish ABN
Form CMS-R-131 Advanced Beneficiary Notice of Noncoverage
Instruction
Total burden requested under this ICR: 63601300 7420364 0  
To view an IC, click on IC Title