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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

2022 National Survey on Drug Use and Health (NSDUH)

WEBOMB 0930-0110. The NSDUH (formerly the National Household Survey on Drug Abuse) is a survey of the civilian, noninstitutionalized population of the United States, age 12 and …

Category:  Health Go Health

Assurance and Certification of Compliance (NPRM)

WEBOMB 0945-0008. Requiring certain recipients and applicants to assure and certify compliance serves two purposes. First, through the act of reading and reviewing the …

Category:  Health Go Health

Medical Source Opinion of Patient’s Capability to Manage Benefits

WEBOMB 0960-0024. SSA collects medical evidence on Form SSA-787 to: (1) determine beneficiaries’ capability or inability to handle their own benefits; and (2) assist in …

Category:  Medical Go Health

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

Category:  Health Go Health

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

OF 178 Certificate of Medical Examination

WEBName. Form OF 178 Certificate of Medical Examination. Form and Instruction. SSA_3206-0250 of 1781.DOC. Supporting Statement A. 30 day notice of 178.pdf. Supplementary …

Category:  Medical 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

The Childcare Survey of Activity and Wellness (C-SAW) Pilot Study

WEBOMB.report. HHS/CDC. OMB 0920-1277. OMB 0920-1277. This project aims to collect information from a sample of early care and education (ECE) directors in 4 states to …

Category:  Health Go Health

National Implementation of the Outpatient and Ambulatory …

WEBThe information collected in the national implementation of OAS CAHPS will be used for the following purposes: -To provide a source of information from which selected measures …

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

Health Insurance Benefit Agreement and Supporting Regulations …

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

Category:  Health Go Health

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.

Category:  Health Go Health

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 …

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

Health Eligibility Center (HEC) Income Verification (IV) Forms

WEBThe latest form for Health Eligibility Center (HEC) Income Verification (IV) Forms expires 2020-06-30 and can be found here. Latest Forms, Documents, and Supporting Material. …

Category:  Health Go Health

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 …

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 & …

Category:  Health Go Health

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 …

Category:  Health Go Health

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