ICR Documents

Supporting Statement A Document Date Uploaded CMS-10565 - Supporting Statement_clean.docx 12/18/2025 Supporting Statement B Document Date Uploaded Supplementary Documents Title Document Document Type Date Uploaded Crosswalk Crosswalk Attachment A_CMS 10565 .docx Supplementary Document 12/18/2025 Response to comments (60-day) MOC PRA 60-comments and response.docx Supplementary Document 06/17/2025 Response to comments (30-day) MOC PRA 30-comments and response_clean.docx Supplementary Document 08/25/2025 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received Fine, N AmeriHealth Caritas- all sheets.pdf AmeriHealth Caritas Email Multiple 02/25/2025 02/25/2025 Paone , Deborah e Special Needs Plan Alliance.pdf Performance Evaluation Lead & Policy Consultant SNP Alliance Email Simple 02/26/2025 02/26/2025 Phillips, Annie CalOptima Health.pdf Orange County Health Authority CalOptima Health Email Simple 02/25/2025 02/25/2025 Berge, Gregory Kaiser Permanente.pdf Kaiser Permanente Email Simple 03/04/2025 03/04/2025 Counsell, Steven Indiana Family and Social Services Administration.pdf Indiana Family and Social Services Administration Email Multiple 03/04/2025 03/04/2025 Martin, Jennifer UHC Comments - Medicare Advantage Model of Care Submission Requirements_7.23.2025.pdf UnitedHealthcare Other -- Reginfo.gov Simple 07/23/2025 07/23/2025 Anonymous PC_202506-0938-009_072325_041406_1.pdf Other -- Reginfo.gov Simple 07/23/2025 07/23/2025 , Johnathan Trualta.pdf Trualta Email Simple 03/04/2025 03/04/2025 Anonymous Point32Health.pdf Point32Health Email Simple 03/05/2025 03/05/2025 Martin, Jennifer UHC Comments - Medicare Advantage Model of Care Submission Requirements.pdf Director, Regulatory Affairs UHC Email Simple 02/24/2025 02/24/2025