PRA Listing

Information collections available for public comment.

CMS Form Number	Date	Subject
CMS Form Number CMS-10439	Date 2023-12-22	Subject Data Collection to Support Eligibility Determinations for Small Businesses in the Small Business Health Options Program
CMS Form Number CMS-10716	Date 2023-06-06	Subject Applicable Integrated Plan Coverage Decision Letter
CMS Form Number CMS-10453	Date 2023-06-06	Subject Medicare Advantage and Prescription Drug Programs: Part C and Part D Explanation of Benefits
CMS Form Number CMS-1450	Date 2023-06-06	Subject Medicare Uniform Institutional Provider Bill
CMS Form Number CMS-2728	Date 2023-06-02	Subject End Stage Renal Disease Medical Evidence Report Medicare Entitlement and/or Patient Registration
CMS Form Number CMS-855S	Date 2023-05-30	Subject Medicare Enrollment Application - Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers
CMS Form Number CMS-10728	Date 2023-05-30	Subject Value in Opioid Use Disorder Treatment Demonstration
CMS Form Number CMS-10401	Date 2023-05-18	Subject Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment
CMS Form Number CMS-1728-20	Date 2023-05-11	Subject Home Health Agency Cost Report
CMS Form Number CMS-10224	Date 2023-05-11	Subject CMS HCPCS Modification to Code Set Form
CMS Form Number CMS-855A	Date 2023-05-04	Subject Medicare Enrollment Application for Institutional Providers
CMS Form Number CMS-R-246	Date 2023-05-04	Subject Medicare Advantage, Medicare Part D, and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey
CMS Form Number CMS-10398 #59	Date 2023-05-04	Subject Medicaid Section 1115 Severe Mental Illness and Children with Serious Emotional Disturbance Demonstrations
CMS Form Number CMS-10174	Date 2023-05-03	Subject Collection of Prescription Drug Event Data From Contracted Part D Providers for Payment
CMS Form Number CMS-10853	Date 2023-05-02	Subject Patient Provider Dispute Resolution Requirements Related to Surprise Billing: Part II
CMS Form Number CMS-10409	Date 2023-05-01	Subject LTCH CARE Data Set For the Collection of Data Pertaining to the Long-Term Care Hospital Quality Reporting Program
CMS Form Number CMS-10717	Date 2023-05-01	Subject Medicare Part C and Part D Program Audit and Industry-Wide Part C Timeliness Monitoring Project (TMP) Protocols
CMS Form Number CMS-10316	Date 2023-04-28	Subject Implementation of the Medicare Prescription Drug Plan (PDP) and Medicare Advantage (MA) Plan Disenrollment Reasons Survey
CMS Form Number CMS-10243	Date 2023-04-28	Subject Testing Experience and Functional Tools: Functional Assessment Standardized Items (FASI) Based on the CARE Tool
CMS Form Number CMS-10260	Date 2023-04-28	Subject Medicare Advantage and Prescription Drug Program: Final Marketing Provisions in 42 CFR 422.111(a)(3) and 423.128(a)(3)
CMS Form Number CMS-367A & E	Date 2023-04-28	Subject Medicaid Drug Rebate Program Labeler Reporting Format
CMS Form Number CMS-10840	Date 2023-04-27	Subject Agent/Broker Consent Information Collection
CMS Form Number CMS-10849	Date 2023-04-25	Subject Drug Price Negotiation Process under Sections 11001 and 11002 of the Inflation Reduction Act (IRA)
CMS Form Number CMS-10844	Date 2023-04-24	Subject Small Biotech Exception
CMS Form Number CMS-10302	Date 2023-04-21	Subject Collection Requirements for Compendia for Determination of Medically-accepted Indications for Off-label Uses of Drugs and Biologicals in an Anti-cancer Chemotherapeutic Regimen
CMS Form Number CMS-10305	Date 2023-04-17	Subject Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(j)
CMS Form Number CMS-10527	Date 2023-04-17	Subject Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices
CMS Form Number CMS-10110	Date 2023-04-17	Subject Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biologicals and Supporting Regulations in 42 CFR 414.800-806
CMS Form Number CMS-10344	Date 2023-04-17	Subject Elimination of Cost Sharing for Full Benefit Dual Eligible Individuals Receiving Home and Community-Based Services
CMS Form Number CMS-10537	Date 2023-04-17	Subject CAHPS Hospice Survey
CMS Form Number CMS-10242	Date 2023-04-11	Subject Emergency Ambulance Transports and Beneficiary Signature
CMS Form Number CMS-10398 #37	Date 2023-04-10	Subject Managed Care Rate Setting Guidance
CMS Form Number CMS-10036	Date 2023-04-07	Subject IRF-PAI for the collection of data pertaining to the Inpatient Rehabilitation Facility Prospective Payment System and Quality Reporting Program
CMS Form Number CMS-10852	Date 2023-04-04	Subject CoreQ: Short Stay Discharge Survey
CMS Form Number CMS-10108	Date 2023-04-04	Subject Medicaid Managed Care and Supporting Regulations
CMS Form Number CMS-10003	Date 2023-04-04	Subject Notice of Denial of Medical Coverage (or Payment) (NDMCP)
CMS Form Number CMS-10708	Date 2023-04-04	Subject Proposed Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Process and Requirements for a Potential National Model
CMS Form Number CMS-10062	Date 2023-03-30	Subject Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments
CMS Form Number CMS-10275	Date 2023-03-30	Subject CAHPS Home Helath Care Survey
CMS Form Number CMS-10221	Date 2023-03-27	Subject Independent Diagnostic Testing Facilities (IDTFs) Site Investigation Form Revisions
CMS Form Number CMS-10788	Date 2023-03-27	Subject Prescription Drug and Health Care Spending
CMS Form Number CMS-10847	Date 2023-03-21	Subject Negotiation Data Elements under Sections 11001 and 11002 of the Inflation Reduction Act
CMS Form Number CMS-10488	Date 2023-03-20	Subject Consumer Experience Survey Data Collection
CMS Form Number CMS-P-0015A	Date 2023-03-20	Subject Medicare Current Beneficiary Survey (MCBS
CMS Form Number CMS-10261	Date 2023-03-14	Subject Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a)
CMS Form Number CMS-437A & 437B	Date 2023-03-10	Subject Rehabilitation Unit & Hospital Criteria Worksheet
CMS Form Number CMS-10834	Date 2023-03-10	Subject Requirement for Electronic Prescribing for Controlled Substances (EPCS) for a Covered Part D Drug Under a Prescription Drug Plan or an MA–PD Plan
CMS Form Number CMS-10836	Date 2023-03-10	Subject Medicare Plan Performance Warning Information
CMS Form Number CMS-416	Date 2023-03-10	Subject Annual Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Participation Report
CMS Form Number CMS-R-297	Date 2023-03-06	Subject Request for Employment Information
CMS Form Number CMS-4040	Date 2023-03-06	Subject Request for Enrollment in Supplementary Medical Insurance (SMI)
CMS Form Number CMS-10839	Date 2023-02-28	Subject Medicare Disproportionate Share Hospital (DSH) Payments: Counting Days Associated with Section 1115 Demonstrations in the Medicaid Fraction
CMS Form Number CMS-R-266	Date 2023-02-24	Subject Medicaid Disproportionate Share Hospital (DSH) Annual Reporting Requirements
CMS Form Number CMS-10141	Date 2023-02-15	Subject Medicare Prescription Drug Benefit Program
CMS Form Number CMS-10398 #79	Date 2023-02-10	Subject COVID–19 Risk Corridor Reconciliation Reporting Template
CMS Form Number CMS-10731	Date 2023-02-07	Subject Generic Clearance for CMS and Medicare Administrative Contractor (MAC) Generic Customer Experience
CMS Form Number CMS-10846	Date 2023-02-07	Subject Medicare Part D Manufacturer Discount Program Agreement
CMS Form Number CMS-R-262	Date 2023-02-07	Subject CMS Plan Benefit Package (PBP) and Formulary CY 2024
CMS Form Number CMS-10387	Date 2023-02-07	Subject Minimum Data Set 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) for the Collection of Data Related to the Patient Driven Payment Model and the Skilled Nursing Facility Quality Reporting Program (QRP)
CMS Form Number CMS-R-282	Date 2023-02-07	Subject Medicare Advantage Appeals and Grievance Data Form
CMS Form Number CMS-10704	Date 2023-02-07	Subject Health Reimbursement Arrangements and Other Account-Based Group Health Plans
CMS Form Number CMS-10609	Date 2023-02-07	Subject Medicaid Program Face-to-Face Requirements for Home Health Services and Supporting Regulations
CMS Form Number CMS-10227	Date 2023-02-07	Subject PACE State Plan Amendment Preprint
CMS Form Number CMS-10825	Date 2023-02-06	Subject List of Screening Instruments for Housing Stability, Food Security, and Transportation Questions on Health Risk Assessments
CMS Form Number CMS-10824	Date 2023-02-03	Subject Annual Notice of Chance and Evidence of Coverage For Applicable Integrated Plans in States that Require Integrated Materials
CMS Form Number CMS-10653	Date 2023-02-02	Subject Coverage of Certain Preventative Services Under the Affordable Care Act
CMS Form Number CMS-10492	Date 2023-02-02	Subject Data Submission for the Federally-facilitated Exchange User Fee Adjustment
CMS Form Number CMS-10830	Date 2023-01-27	Subject Data Collection to Support CMS Burden Reduction and Health Informatics Efforts
CMS Form Number CMS-10595	Date 2023-01-11	Subject Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection
CMS Form Number CMS-10142	Date 2023-01-10	Subject Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP)
CMS Form Number CMS-10594	Date 2023-01-10	Subject Provider Network Coverage Data Collection
CMS Form Number CMS-10510	Date 2022-12-27	Subject Basic Health Program Supporting Regulations
CMS Form Number CMS-10823	Date 2022-12-20	Subject End-stage Renal Disease (ESRD) Quality Incentive Program (QIP): Study of Quality and Patient Experience
CMS Form Number CMS-10146	Date 2022-12-15	Subject Notice of Denial of Medicare Prescription Drug Coverage
CMS Form Number CMS-10396	Date 2022-12-14	Subject Medication Therapy Management Program Improvements
CMS Form Number CMS-10829	Date 2022-12-14	Subject Improper Payment Pre-Testing and Assessment (IPPTA)
CMS Form Number CMS-10831	Date 2022-12-14	Subject Transitional Coverage and Retroactive Medicare Part D Coverage for Certain Low-Income Beneficiaries through the Limited Income Newly Eligible Transition (LI NET) Program
CMS Form Number CMS-R-267	Date 2022-12-14	Subject Medicare Advantage Program and Supporting Regulations
CMS Form Number CMS-10718	Date 2022-12-14	Subject Model Medicare Advantage and Medicare Prescription Drug Plan Individual Enrollment Request Form
CMS Form Number CMS-R-131	Date 2022-11-25	Subject Advance Beneficiary Notice of Noncoverage (ABN)
CMS Form Number CMS-10816	Date 2022-11-25	Subject Medicare Part C and Medicare Part D Enrollment Form Interviews
CMS Form Number CMS-10835	Date 2022-11-18	Subject Dispute Resolution for Discarded Drug Refunds (CMS-10835)
CMS Form Number CMS-10556	Date 2022-11-17	Subject Medical Necessity and Contract Amendments Under Mental Health Parity
CMS Form Number CMS-10379	Date 2022-11-04	Subject Rate Increase Disclosure and Review Requirements
CMS Form Number CMS-10789	Date 2022-11-04	Subject Customer Satisfaction Survey for Enterprise Portal Services (EPS) Users
CMS Form Number CMS-1771	Date 2022-11-03	Subject Emergency and Foreign Hospital Services and Supporting Regulation in 42 CFR Section 424.103
CMS Form Number CMS-10398 #7	Date 2022-11-01	Subject Connecting Kids to Coverage Outreach and Enrollment
CMS Form Number CMS-10079	Date 2022-10-25	Subject Hospital Wage Index Occupational Mix Survey
CMS Form Number CMS-R-244	Date 2022-10-21	Subject Programs of All-Inclusive Care for the Elderly (PACE) and Supporting Regulations
CMS Form Number CMS-10237	Date 2022-10-12	Subject Applications for Part C Medicare Advantage, 1876 Cost Plans, and Employer Group Waiver Plans to Provide Part C Benefits
CMS Form Number CMS-10137	Date 2022-10-12	Subject Solicitation for Applications for Medicare Prescription Drug Plan 2024 Contracts
CMS Form Number CMS-10628	Date 2022-10-12	Subject Initial Request for State Implemented Moratorium Form
CMS Form Number CMS-R-5	Date 2022-09-29	Subject Physician Certifications/Recertifications in Skilled Nursing Facilities Manual Instructions
CMS Form Number CMS-10691	Date 2022-09-29	Subject Data Request and Attestation for PDP Sponsors
CMS Form Number CMS-643	Date 2022-09-23	Subject Hospice Survey and Deficiencies Report Form and Supporting Regulations
CMS Form Number CMS-379	Date 2022-09-15	Subject Financial Statement of Debtor
CMS Form Number CMS-10328	Date 2022-09-07	Subject Medicare Self-Referral Disclosure Protocol
CMS Form Number CMS-10430	Date 2022-08-24	Subject Compliance with Individual and Group Market Reforms under Title XXVII of the Public Health Service Act
CMS Form Number CMS-10611	Date 2022-08-24	Subject Medicare Outpatient Observation Notice
CMS Form Number CMS-10065 and 10066	Date 2022-08-24	Subject Hospital Notices: IM/DND
CMS Form Number cms-10744	Date 2022-08-05	Subject Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program – Contracting Forms
CMS Form Number CMS-R-305	Date 2022-08-05	Subject External Quality Review (EQR) of Medicaid and Children’s Health Insurance Program (CHIP) Managed Care, EQR Protocols, and Supporting Regulations
CMS Form Number CMS-10553	Date 2022-08-05	Subject Medicaid Managed Care Quality including Supporting Regulations
CMS Form Number CMS-10621	Date 2022-07-29	Subject Quality Payment Program/Merit-Based Incentive Payment System (MIPS)
CMS Form Number CMS-10105	Date 2022-07-15	Subject National Implementation of the In-Center Hemodialysis CAHPS Survey
CMS Form Number CMS-460	Date 2022-07-15	Subject Medicare Participation Agreement for Physicians and Suppliers
CMS Form Number CMS-10052	Date 2022-07-15	Subject Recognition of pass-through payment for additional (new) categories of devices under the Outpatient Prospective Payment System and Supporting Regulations
CMS Form Number CMS-2552-10	Date 2022-06-22	Subject Hospital and Hospital Health Care Complex Cost Report
CMS Form Number CMS-10407	Date 2022-06-13	Subject Summary of Benefits and Coverage Uniform Glossary
CMS Form Number CMS-10668	Date 2022-06-13	Subject Quality Measures and Administrative Procedures for the Hospital-Acquired Condition Reduction Program
CMS Form Number CMS-10779	Date 2022-06-02	Subject Complaints Submission Process under the No Surprises Act
CMS Form Number CMS-10418	Date 2022-06-02	Subject Medical Loss Ratio Annual Reports, MLR Notices, and Recordkeeping Requirements
CMS Form Number CMS-10630	Date 2022-05-10	Subject The PACE Organization (PO) Monitoring and Audit Process in 42 CFR Part 460
CMS Form Number CMS-10666	Date 2022-05-06	Subject Information Collection Requirements for Non-Exchange Entities
CMS Form Number CMS-265-11	Date 2022-05-05	Subject Independent Renal Dialysis Facility Cost Report
CMS Form Number CMS-10544	Date 2022-05-05	Subject Good Cause Processes
CMS Form Number CMS-10631	Date 2022-04-29	Subject The PACE Organization Application Process in 42 CFR Part 460
CMS Form Number CMS-10791	Date 2022-04-28	Subject Requirements Related to Surprise Billing; Part II
CMS Form Number CMS-R-235	Date 2022-04-25	Subject Data Use Agreement (DUA) Form, Research Identifiable Files Request Packet, and Data Management Plan
CMS Form Number CMS-10680	Date 2022-04-13	Subject Electronic Visit Verification Compliance Survey
CMS Form Number CMS-10692	Date 2022-04-13	Subject Home and Community Based Services (HCBS) Incident Management Survey
CMS Form Number CMS-10495	Date 2022-04-12	Subject Data Collection and Submission, Registration, Attestation, Dispute and Resolution, Record Retention, and Assumptions Document Submission, for Open Payments
CMS Form Number CMS-10511	Date 2022-04-06	Subject Medicare Coverage of Items and Services in FDA Investigational Device Exemption Clinical Studies-Revision of Medicare Coverage (CMS-1600-F)
CMS Form Number CMS-10394	Date 2022-04-04	Subject Application and Triennial Re-application to Be a Qualified Entity to Receive Medicare Data for Performance Measurement
CMS Form Number CMS-10433	Date 2022-03-29	Subject Continuation of Data Collection to Support QHP Certification and other Financial Management and Exchange Operations
CMS Form Number CMS-10398 #76	Date 2022-03-29	Subject Expressions of interest in the Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Affinity Group
CMS Form Number CMS-10398 #74	Date 2022-03-29	Subject Coverage of Routine Patient Cost for Items & Services in Qualifying Clinical Trials
CMS Form Number CMS-R-284	Date 2022-03-24	Subject Transformed-Medicaid Statistical Information System (T-MSIS
CMS Form Number CMS-10573	Date 2022-03-15	Subject Reform of Requirements for Long-Term Care Facilities
CMS Form Number CMS-906	Date 2022-03-04	Subject Fiscal Soundness Reporting Requirements (FSRR)
CMS Form Number CMS-10398 #64	Date 2022-03-03	Subject Medicaid Section 1115 Substance Use Disorder (SUD) Demonstrations: Federal Meta-Analysis Support
CMS Form Number CMS-10398 #57	Date 2022-02-24	Subject Medicaid Section 1115 Substance Use Disorder (SUD) Demonstration: Monitoring Reports Documents and Templates
CMS Form Number CMS-R-306	Date 2022-02-22	Subject Use of Restraint and Seclusion in Psychiatric Residential Treatment Facilities (PRTFs) for Individuals Under Age 21 and Supporting Regulations
CMS Form Number CMS-R-74	Date 2022-02-22	Subject Income and Eligibility Verification System
CMS Form Number CMS-10575	Date 2022-02-22	Subject Generic Clearance for the Heath Care Payment Learning and Action Network
CMS Form Number CMS-10391	Date 2022-02-22	Subject Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204
CMS Form Number CMS-10792	Date 2022-02-22	Subject Patient-Reported Indicator Survey (PaRIS)
CMS Form Number CMS-10786	Date 2022-02-22	Subject SUPPORT Act Section 1003 Demonstration Evaluation
CMS Form Number CMS-3427	Date 2022-02-16	Subject End Stage Renal Disease Application and Survey and Certification Report
CMS Form Number CMS-10545	Date 2022-02-09	Subject Outcome and Assessment Information Set OASIS-E
CMS Form Number CMS-10793	Date 2022-02-04	Subject Medicare Advantage and Prescription Drug Plan Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey Field Test
CMS Form Number CMS-10157	Date 2022-01-26	Subject The HIPAA Eligibility Transaction System (HETS)
CMS Form Number CMS-10398 #17	Date 2022-01-19	Subject CHIP State Plan Eligibility
CMS Form Number CMS-276	Date 2022-01-18	Subject Prepaid Health Plan Cost Report
CMS Form Number CMS-10790	Date 2022-01-11	Subject Medicare-Funded GME Residency Positions in accordance with Section 126 of the Consolidated Appropriations Act, 2020 (Public Law 116-93)
CMS Form Number CMS-10398 #13	Date 2022-01-07	Subject Medicaid Accountability – Nursing Facility, Outpatient Hospital and Inpatient Hospital Upper Payment Limits
CMS Form Number CMS-10398 #24	Date 2022-01-07	Subject Medicaid Accountability – Upper Payment Limits for Clinics, Physician Services, ICF/IID, PRTFs, and IMDs
CMS Form Number CMS-10398 #73	Date 2022-01-07	Subject Supplemental Payment Reporting under the Consolidated Appropriations Act, 2021
CMS Form Number CMS-10398 #75	Date 2022-01-07	Subject ARP 1135 State Plan Amendment
CMS Form Number CMS-10476	Date 2022-01-06	Subject Medical Loss Ratio (MLR) Report for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP)
CMS Form Number CMS-10636	Date 2022-01-06	Subject Triennial Network Adequacy Review for Medicare Advantage Organizations and 1876 Cost Plans
CMS Form Number CMS-10802	Date 2022-01-06	Subject Medicare Advantage and Prescription Drug Program: Final Marketing Provisions in 42 CFR 422.111(h)(1)(iii) and 423.128(d)(1)(iii)
CMS Form Number CMS-10799	Date 2022-01-06	Subject D-SNP Enrollee Advisory Committee and SNP Standardized Questions on Health Risk Assessments
CMS Form Number CMS-10796	Date 2022-01-06	Subject Dual Eligible Special Needs Plan Contract with the State Medicaid Agency
CMS Form Number CMS-10410	Date 2022-01-05	Subject Medicaid Program; Eligibility Changes under the Affordable Care Act of 2010
CMS Form Number CMS-10554	Date 2022-01-05	Subject Children?s Health Insurance Program Managed Care and Supporting Regulations
CMS Form Number CMS-10633	Date 2021-12-27	Subject QIC Demonstration Evaluation Contractor (QDEC): Analyze Medicare Appeals to Conduct Formal Discussions and Re-openings with Suppliers Appeals to Conduct Formal Discussions and Re-openings With Suppliers
CMS Form Number CMS-R-153	Date 2021-12-10	Subject Medicaid Drug Use Review (DUR) Program
CMS Form Number CMS-10330	Date 2021-11-26	Subject Notice of Rescission of Coverage and Disclosure Requirements for Patient Protection under the Affordable Care Act
CMS Form Number CMS-10341	Date 2021-11-19	Subject Section 1115 Demonstration Projects Regulations at 42 CFR 431.408, 431.412, 431.420, 431.424, and 431.428
CMS Form Number CMS-10463	Date 2021-10-22	Subject Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Exchanges
CMS Form Number CMS-2567	Date 2021-10-22	Subject Statement of Deficiencies and Plan of Correction
CMS Form Number CMS-216-94	Date 2021-10-15	Subject Organ Procurement Organization/Histocompatibility Laboratory Cost Report
CMS Form Number CMS-10552	Date 2021-10-14	Subject Implementation of Medicare and Medicaid Programs; - Promoting Interoperability Programs Stage 3
CMS Form Number CMS-10784	Date 2021-10-14	Subject The Home Health Care CAHPS® Survey (HHCAHPS) Mode Experiment
CMS Form Number CMS-10417	Date 2021-10-05	Subject Medicare Fee-for-Service Prepayment Medical Review
CMS Form Number CMS-10783	Date 2021-09-28	Subject Generic Beneficiary & Family Centered-Care Quality Improvement Organization (BFCC-QIO) Data Collection Research
CMS Form Number CMS-10787	Date 2021-09-16	Subject Agent and Broker Disclosure and Reporting Requirements
CMS Form Number CMS-10785	Date 2021-09-16	Subject Reporting Requirements Regarding Air Ambulance Services
CMS Form Number CMS-10765	Date 2021-09-08	Subject Review Choice Demonstration for Inpatient Rehabilitation Facility (IRF) Services
CMS Form Number CMS-179	Date 2021-08-25	Subject Medicaid State Plan Base Plan Pages
CMS Form Number CMS-10775	Date 2021-08-06	Subject Medicare Severity Diagnosis Related Groups Reclassification Request (MS-DRGs)
CMS Form Number CMS-10398 #72	Date 2021-07-30	Subject Expressions of Interest in the Infant Well-Child Visit Affinity Group
CMS Form Number CMS-10701	Date 2021-07-29	Subject Medicare Beneficiary Experiences with Care Survey (MBECS) System
CMS Form Number CMS-10500	Date 2021-07-26	Subject National Implementation of the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey
CMS Form Number CMS-10781	Date 2021-07-23	Subject FOIA/Privacy Act Requests for Medicare Claims Data via CMS FOIA Public Portal
CMS Form Number CMS-10572	Date 2021-07-23	Subject Transparency in Coverage Reporting by Qualified Health Plan Issuers
CMS Form Number CMS-10008	Date 2021-07-21	Subject Transitional Pass through payments related to Drugs, Biologicals, and Radiopharmaceuticals to determine eligibility under the Outpatient Prospective Payment System
CMS Form Number CMS-10774	Date 2021-07-21	Subject The International Classification of Diseases, 10th Revision, Procedure Coding System (ICD–10–PCS)
CMS Form Number CMS-10769	Date 2021-07-02	Subject Evaluation of the CMS Network of Quality Improvement and Innovation Contractors Program (NQIIC)
CMS Form Number CMS-10185	Date 2021-06-24	Subject Medicare Part D Reporting Requirements
CMS Form Number CMS-10773	Date 2021-06-16	Subject Non-Quantitative Treatment Limitation Analyses and Compliance Under MHPAEA
CMS Form Number CMS-10773	Date 2021-06-16	Subject Non-Quantitative Treatment Limitation Analyses and Compliance Under MHPAEA
CMS Form Number CMS-R-308	Date 2021-06-14	Subject State Children's Health Insurance Program and Supporting Regulations
CMS Form Number CMS-1696	Date 2021-05-24	Subject Appointment of Representative and Supporting Regulations in 42 CFR
CMS Form Number CMS-10241	Date 2021-05-21	Subject Fee-for-Service Recovery Audit Prepayment Review Demonstration and Prior Authorization Demonstration
CMS Form Number CMS-10764	Date 2021-05-20	Subject Evaluation of Risk Adjustment Data Validation (RADV) Appeals and Health Insurance Exchange Outreach Training Sessions
CMS Form Number CMS-10536	Date 2021-05-20	Subject Medicaid Eligibility and Enrollment (EE) Implementation Advanced Planning Document (IAPD) Template
CMS Form Number CMS-10398 #69	Date 2021-05-20	Subject Reporting Requirements for Additional Funding for Medicaid HCBS During the COVID–19 Emergency
CMS Form Number CMS-10166	Date 2021-05-18	Subject Fee-for-Service Improper Payment Rate Measurement in Medicaid and the Children’s Health Insurance Program
CMS Form Number CMS-10178	Date 2021-05-18	Subject Medicaid and Children’s Health Insurance (CHIP) Managed Care Payments and Related Information
CMS Form Number cms-10184	Date 2021-05-18	Subject Payment Error Rate Measurement – State Medicaid and CHIP Eligibility
CMS Form Number CMS-10398 #71	Date 2021-05-17	Subject Reporting Requirements for State Planning Grants for Qualifying Community-Based Mobile Crisis Intervention Services During the COVID–19 Emergency
CMS Form Number CMS-10450	Date 2021-05-03	Subject Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for the Merit-Based Incentive Payment System (MIPS)
CMS Form Number CMS-10340	Date 2021-04-28	Subject Collection of Encounter Data from MA Organizations
CMS Form Number CMS-855O	Date 2021-04-09	Subject Medicare Enrollment Application
CMS Form Number CMS-10432	Date 2021-04-07	Subject Revised and New Procedural Requirements for the FY 2020 Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program
CMS Form Number CMS-10147	Date 2021-03-25	Subject Medicare Prescription Drug Coverage and Your Rights
CMS Form Number CMS-10398	Date 2021-03-19	Subject Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions
CMS Form Number CMS-10198	Date 2021-03-18	Subject Creditable Coverage Disclosure to CMS On-Line Form and Instructions
CMS Form Number CMS-1984-14	Date 2021-03-03	Subject Hospice Facility Cost Report
CMS Form Number CMS-10054	Date 2021-03-02	Subject New Technology Services for Ambulatory Payment Classifications under the Outpatient Prospective Payment System
CMS Form Number CMS-368 and R-144	Date 2021-02-23	Subject Medicaid Drug Rebate State Reporting Program Forms
CMS Form Number CMS-304 and 304a	Date 2021-02-23	Subject Reconciliation of State Invoice (ROSI) and Prior Quarter Adjustment Statement (PQAS)
CMS Form Number CMS-10326	Date 2021-02-18	Subject Electronic Submission of Medicare Graduate Medical Education (GME) Affiliation Agreements
CMS Form Number CMS-R-148	Date 2021-02-08	Subject Limitations on Provider Related Donations and Health Care Related Taxes, Medicaid and Supporting Regulations in 42 CFR 433.68 through 433.74
CMS Form Number CMS-2088-17	Date 2021-02-05	Subject Community Mental Health Center Cost Report and Supporting Regulations
CMS Form Number CMS-1763	Date 2021-02-05	Subject Request for Termination of Premium Hospital and Supplementary Medical Insurance
CMS Form Number CMS-10518	Date 2021-02-01	Subject Application for Participation in the Intravenous Immune Globulin (IVIG) Demonstration
CMS Form Number CMS-10434	Date 2019-08-15	Subject Medicaid and CHIP Program (MACPro)
CMS Form Number CMS-588	Date 0222-12-22	Subject Electronic Funds Transfer (EFT) Authorization Agreement
CMS Form Number	Date	Subject