Medicare Part C and Part D Data Validation (42 C.F.R. 422.516g and 423.514g) - (CMS-10305)

Medicare Part C and Part D Data Validation (42 C.F.R. 422.516g and 423.514g)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1115 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10305 Medicare Part C and Part D Data Validation (42 C.F.R. 422.516g and 423.514g) - (CMS-10305) Form and Instruction
2 DRAFT_Data Extraction and Sampling Instructions_20100826_508.pdf Instruction
3 DRAFT Data Validation Standards 20100826_508.pdf Instruction
4 DRAFT Findings Data Collection Form Intro_20100826_508.pdf Instruction
CMS-10305 Medicare Part C and Part D Measure Organizational Assess 1 DRAFT Organizational Assessment Instrument 20100826_508.pdf Form and Instruction
CMS-10305 Findings Data Collection Form: Benefit Utilization 5 DRAFT Findings Data Collection Form_20100826_508.pdf Form

Information Collection (IC) Details

IC Title:	Medicare Part C and Part D Data Validation (42 C.F.R. 422.516g and 423.514g) - (CMS-10305)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 422.516_(a)(1),(a)(2) 42 CFR 422.516(a)(3),(a)(4),(a)(6) 42 CFR 423.514 (a)(1) (a) (2) 42 CFR 423.514 (a)(3) (a) (4) (a) (6)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10305	Medicare Part C and Part D Measure Organizational Assessment Instrument	1 DRAFT Organizational Assessment Instrument 20100826_508.pdf	Yes	Yes	Paper Only
Instruction			2 DRAFT_Data Extraction and Sampling Instructions_20100826_508.pdf	Yes	Yes	Paper Only
Instruction			3 DRAFT Data Validation Standards 20100826_508.pdf	Yes	Yes	Paper Only
Instruction			4 DRAFT Findings Data Collection Form Intro_20100826_508.pdf	Yes	Yes	Paper Only
Form	CMS-10305	Findings Data Collection Form: Benefit Utilization	5 DRAFT Findings Data Collection Form_20100826_508.pdf	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 634	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	634	634
Annual IC Time Burden (Hours)	237,127	237,127
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.