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Home Health Agency Survey and Deficiencies Report and …

WEBIn order to participate in the Medicare program as a Home Health Agency (HHA) provider, the HHA must meet Federal standards. The survey forms summarize data relative to …

Actived: 2 days ago

URL: https://omb.report/omb/0938-0355

Application For Enrollment in Medicare Part B

WEBIf you sign up in a SEP, include the. CMS-L564 with your Part B application. If you have questions, call Social Security at 1-800-772-1213. TTY users should call. 1-800-325 …

Category:  Health Go Health

Electronic Visit Verification (EVV) Compliance Survey (CMS-10680)

WEBOMB.report. HHS/CMS. OMB 0938-1360. OMB 0938-1360. This collection entails an electronic, web-based survey that will allow states to self-report their progress in …

Category:  Health Go Health

2022 National Survey on Drug Use and Health (NSDUH)

WEBOMB 0930-0110. OMB 0930-0110. The NSDUH (formerly the National Household Survey on Drug Abuse) is a survey of the civilian, noninstitutionalized population of the United …

Category:  Health Go Health

National Syndromic Surveillance Program

WEBHHS/CDC. OMB 0920-0824. OMB 0920-0824. The National Syndromic Surveillance Program (previously called BioSense) supports the sharing and use of high …

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Centers for Medicare & Medicaid Services CMS

WEBMedicare Enrollment Application for Registration of Eligible Entities That Provide Health Insurance Coverage Complementary to Medicare Part B and Supporting Regulations. …

Category:  Health Go Health

Performance Progress and Monitoring Report

WEBOMB 0920-1132. The Centers for Disease Control and Prevention (CDC) seeks OMB approval for a Revision to the Performance Progress and Monitoring Report (0920 …

Category:  Health Go Health

Health Benefits Election Form

WEBOMB 3206-0160. The SF 2809 is used by Federal employees, annuitants other than those under the Civil Service Retirement System (CSRS) and the Federal …

Category:  Health Go Health

Request for Employment Information (CMS-R-297/CMS-L564)

WEBThe latest form for Request for Employment Information (CMS-R-297/CMS-L564) expires 2023-06-30 and can be found here. Office of Management and Budget control number …

Category:  Health Go Health

Survey of Healthcare Experiences of Patients (SHEP)

WEBVA. OMB 2900-0712. OMB 2900-0712. The overall purpose of the VHA Office of Quality and Performance Survey of Health Experience of Patients (SHEP) Survey Program is to …

Category:  Health Go Health

Health Insurance Benefit Agreement and Supporting Regulations …

WEBOMB 0938-0832. OMB 0938-0832. Applicants to the Medicare program are required to agree to provide services in accordance with Federal requirements. The CMS-1561 and …

Category:  Health Go Health

Request for Employment Information

WEBfor more information. TTY users can call 1-877-486-2048. Form CMS L564/R297 (08/20) 1. fDEPARTMENT OF HEALTH AND HUMAN SERVICES. CENTERS FOR MEDICARE & …

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Health Insurance Common Claims Form and Supporting …

WEBHealth Insurance Common Claims Form and Supporting Regulations at 42 CFR Part 424, Subpart C (CMS-1500 and CMS-1490S) OMB 0938-1197. OMB.report

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VA Health Benefits: Application, Update, Hardship Determination

WEBNon-substantive updates have been made to VA Forms 10-10EZ and 10-10EZR to bring these forms into compliance with the MISSION Act of 2018. The forms collect …

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OPM 2809, Health Benefits Election Form

WEBOPM Form 2809 is used by annuitants and former spouses to elect, cancel, suspend, or change health benefits enrollment during periods other than open season.

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Notice to Employees of Coverage Options Under Fair Labor …

WEBThe model notice is being to provided by the Department to facilitate compliance with FLSA section 18B. The latest form for Notice to Employees of …

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The Family and Medical Leave Act of 1993, As Amended

WEBOMB 1235-0003. OMB 1235-0003. This ICR implements statutory notice and certification provisions and to assist employees and employers in meeting their FMLA third-party …

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State Home Programs for Veterans

WEBThis information collection, under OMB Control Number 2900-0160, now includes only three forms: VA Forms 10-5588, 10-5588A, and 10-10SH. The latest form for State Home …

Category:  Health Go Health

N-648, Medical Certification for Disability Exceptions

WEBInterpreter's Certification. The interpreter must complete and certify the section below if an interpreter interpreted communications between the applicant and medical professional …

Category:  Medical Go Health

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