OMB control number
Medicare Quality of Care Complaint Form (CMS-10287)
OMB 0938-1102 · HHS/CMS.
OMB 0938-1102
Latest Forms, Documents, and Supporting Material
Document Name |
|---|
 Form CMS-10287 Medicare QUALITY OF CARE COMPLAINT FORM (document unavailable)Form and Instruction |
Supporting Statement A |
CMS-10287 Supporting Statement- clean 4-30-25.docx
Medicare Quality of Care Complaint Form All Historical Document Collections
| Reinstatement with change of a previously approved collection | 2026-03-02 | ||
| Reinstatement with change of a previously approved collection | 2020-08-03 | ||
|
Approved with change |
Extension without change of a currently approved collection | 2016-11-23 | |
|
Approved without change |
No material or nonsubstantive change to a currently approved collection | 2014-02-10 | |
|
Approved with change |
Revision of a currently approved collection | 2013-07-30 | |
|
Approved with change |
New collection (Request for a new OMB Control Number) | 2009-10-27 |