ICR Documents

Supporting Statement A Document Date Uploaded CMS--10277 - Supporting Statement - Clean.docx 09/11/2026 Supporting Statement B Document Date Uploaded Supplementary Documents Title Document Document Type Date Uploaded Response to Comments CMS-10277 - Response to Comments.docx Supplementary Document 09/11/2026 Model Example of Hospice Election Statement CMS-10277 - Model Example of Hospice Election Statement.docx Supplementary Document 09/11/2026 Model Example of Hospice Election Statement (SPANISH) CMS-10277 - SPA Model Example of Hospice Election Statement.docx Supplementary Document 09/11/2026 Model Hospice Election Addendum (SPANISH) CMS-10277 - SPA Model Hospice Election Statement Addendum.docx Supplementary Document 09/11/2026 Model Hospice Election Statement Addendum CMS-10277 - Model Hospice Election Statement Addendum.docx Supplementary Document 09/11/2026 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received Silvers, Allison CMS-2026-1156-0011-A1.pdf Chief, Health Care Transformation Center to Advance Palliative Care Other -- Simple 09/11/2026 05/26/2026 Feliciano, MD, MPH, Harry CMS-2026-1156-0065-A1.pdf Principal and Medical Director Decision Assist LLC Letter Simple 04/13/2026 04/13/2026