PRA ICR Documents
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
ICR Documents
Supporting Statement A
Document
Date Uploaded
CMS-10565 - Supporting Statement A (CMS-4190-F2 version 7).docx
08/31/2021
Supporting Statement B
Document
Date Uploaded
Supplementary Documents
Title
Document
Document Type
Date Uploaded
Attachment A Crosswalk: Model of Care Matrix Document: Initial and Renewal Submission
Crosswalk Attachment A CMS 10565 OMB 0938-1296 Final.docx
Supplementary Document
08/31/2021
Attachment B Crosswalk: Model of Care Matrix Document: Off-Cycle Submission
Crosswalk Attachment B CMS 10565 OMB 0938-1296 Final.docx
Supplementary Document
08/31/2021
Public Comments
Author Name
Comment Document
Author Affiliation
Sponsoring Org.
Type
Category
Date of Comment
Date Comment Received
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
An official website of the United States government
The .gov means it's official.
The site is secure.
