Risk Corridors Transitional Policy

Risk Corridors Transitional Policy (CMS-10532)

Documents and Forms

Document Name Document Type
Form CMS-10532 Risk Corridors Transitional Policy Form
CMS-10532 - Transitional Adjustment Reporting Form Instructions (Final) Jan clean.pdf Instruction
CMS-10532 Transitional Policy Reporting Form CMS-10532 Copy of 30 day transitional reporting form_Jan clean v2.xlsx Form
CMS-10532 Memo regarding change to transitional form.docx Modifications to the Updated Version of Transitional Adjustment Data Reporting Form IC Document

Information Collection (IC) Details

IC Title:	Risk Corridors Transitional Policy	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 153.530

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CMS-10532	Transitional Policy Reporting Form	CMS-10532 Copy of 30 day transitional reporting form_Jan clean v2.xlsx		Yes	Yes	Fillable Fileable
Instruction			CMS-10532 - Transitional Adjustment Reporting Form Instructions (Final) Jan clean.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Modifications to the Updated Version of Transitional Adjustment Data Reporting Form	CMS-10532 Memo regarding change to transitional form.docx	02/09/2015

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