Information Collection Request

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

ICR 201311-0938-014 · OMB 0938-1115 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10305 - Supporting Statement part B [rev 11-8-2013 by OSORA PRA].docx Supporting Statement B Uploaded 2013-11-13 Available
Medicare Parts C and D Data Validation Revisions Crosswalk_20121029.pdf Supplementary Document Uploaded 2013-11-13 Available
Crosswalk.CMS_10305.xlsx Supplementary Document Uploaded 2013-11-13 Available
CMS-10305 - Supporting Statement part A [rev 11-8-2013 by OSORA PRA].docx Supporting Statement A Uploaded 2013-11-13 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
194762 Medicare Part C and Part D Data Validation (42 C.F.R. 422.516g and 423.514g) - (CMS-10305) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2017 36 Months From Approved 02/28/2014
657 0 634
179,301 0 237,127
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Medicare Part C and Part D Data Validation (42 C.F.R. 422.516g and 423.514g) - (CMS-10305) CMS-10305, CMS-10305 Appendix 2: Organizational Assessment Instrument ,   Appendix 5: Data Collection Form

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 657 634 0 0 23 0
Annual Time Burden (Hours) 179,301 237,127 0 -55,802 -2,024 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No