Mandatory Insurer Reporting (Non-GHP, State, Local, Tribal Govt., System Set-up and Administration)

Mandatory Insurer Reporting Requirements of Section 111 of the Medicare, Medicaid and SCHIP Act of 2007 (CMS-10265)

OMB: 0938-1074

IC ID: 188584

Information Collection (IC) Details

View Information Collection (IC)

Mandatory Insurer Reporting (Non-GHP, State, Local, Tribal Govt., System Set-up and Administration)
 
No Removed
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10265 Interim Non-GHP Record Layout NGHPInterim120508[1].pdf Yes No Fillable Printable

Health Health Care Services

Medicare Advantage Prescription Drug System (MARx)  70 FR 60530

100 100
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 0 -100 0 100
Annual IC Time Burden (Hours) 0 0 0 -743 0 743
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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