ICR Documents

Supporting Statement A Document Date Uploaded CMS-10791 - Supporting Statement.docx 07/07/2026 Supporting Statement B Document Date Uploaded Supplementary Documents Title Document Document Type Date Uploaded Crosswalk of Changes CMS-10791 - Crosswalk of Changes.docx Supplementary Document 06/24/2026 Appendix 1: Right to Receive Good Faith Estimate (Redline) Appendix 1. Right to Receive a Good Faith Estimate of Expected Charges Notice_12.10.25(redline).docx Supplementary Document 06/24/2026 Appendix 2 - Good Good Faith Estimate (Redline) Appendix 2. Good Faith Estimate Template Notice_12.10.25(redline).docx Supplementary Document 06/24/2026 Appendix 3 - Good Faith Estimate Data Elements (Redline) Appendix 3. Good Faith Estimate Data Elements_12.10.25(redline).docx Supplementary Document 06/24/2026 Response to 60-day Comment 60-day Comment Response.docx Supplementary Document 06/24/2026 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received Anonymous 60-day Comment Response.docx Other -- Simple 06/24/2026 06/24/2026