Transitional Coverage and Retroactive Medicare Part D Coverage for Certain Low-Income Beneficiaries through the Limited Income Newly Eligible Transition (LI NET) Program (CMS-10831)
ICR 202408-0938-003
OMB: 0938-1441
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1441 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Form and Instruction |
Modified |
Supplementary Document | 2024-08-06 |
Supplementary Document | 2024-08-06 |
Supporting Statement A | 2024-08-06 |
Form CMS-10831 Beneficiaries
CMS-10831_LI NET DirectReimbReq 2025v3 Crosswalk_508.pdf
CMS-10831_Supporting Statement__a.docxIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 257782 | Unchanged | ||
| 257781 | Unchanged | ||
| 257780 | Modified |
Sponsor (Report to CMS)ICR Details
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