ICR Documents

Supporting Statement A Document Date Uploaded CMS-10146 - Supporting Statement A - Passback1 rev CLEAN.doc 02/02/2017 Supporting Statement B Document Date Uploaded Supplementary Documents Title Document Document Type Date Uploaded Response to Comments Denial Notice Comment Chart 08242016.docx Supplementary Document 09/16/2016 Response to 30-day Comments 30-day Comment Response Denial Notice Comment Chart 02012017.docx Supplementary Document 02/02/2017 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received Van Ginkel, Joshua 1k0-8pjw-10mv - Comment.pdf OptumRx, Inc. Other -- Web Simple 05/10/2016 05/10/2016 Van Ginkel, Joshua 1k0-8pjw-1x1k - Comments.pdf Optum Other -- Web Simple 05/10/2016 05/10/2016 Hamelburg, Mark 30-day Comment - PartDNoticeofDenial_AHIPComments_10_12_16.pdf America’s Health Insurance Plans (AHIP) Email Simple 10/12/2016 10/12/2016 Hanson, Alison 1k0-8pjv-vzuf - Comment.pdf Other -- Web Simple 05/10/2016 05/10/2016 Rohan, Sue 1k0-8pjv-4992 - Comments.pdf Health Care Service Corporation (HCSC)/Blue Cross and Blue Shield Other -- Web Simple 05/10/2016 05/10/2016 Hamelburg, Mark 1k0-8pjt-idy4 - Comments.pdf America's Health Insurance Plans Other -- Web Simple 05/10/2016 05/10/2016