Information Collection

Medicare+Choice Program Requirements -- 42 CFR 422.000-422.700

IC 8458 under ICR 199812-0938-009 · OMB 0938-0753.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0753 can be found here:

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Information Collection (IC) Details

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IC Title:	Medicare+Choice Program Requirements -- 42 CFR 422.000-422.700	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-R-0267				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000,450	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,657,534	7,657,534
Annual IC Time Burden (Hours)	1,264,535	1,264,535
Annual IC Cost Burden (Dollars)	0	0

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