Applications for Part C Medicare Advantage, 1876 Cost Plans, and Employer Group Waiver Plans to Provide Part C Benefits

Applications for Part C Medicare Advantage, 1876 Cost Plans, and Employer Group Waiver Plans to Provide Part C Benefits (CMS-10237)

OMB: 0938-0935

IC ID: 8785

Information Collection (IC) Details

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Applications for Part C Medicare Advantage, 1876 Cost Plans, and Employer Group Waiver Plans to Provide Part C Benefits
 
No Modified
 
Mandatory
 
42 CFR 422.502 42 CFR 417.400 42 CFR 422.506 42 CFR 422.505 42 CFR 422.514 42 CFR 422.520 42 CFR 422.521 42 CFR 422.500 42 CFR 422.524 42 CFR 422.527 42 CFR 422.503 42 CFR 422.508 42 CFR 422.510 42 CFR 422.512 42 CFR 422.504 42 CFR 422.501 42 CFR 422.516

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10237 Part C -Medicare Advantage and 1876 Cost Plan Expansion Application 4_CY2019 Part C-MA and 1876 Cost Plan Expansion Application-Final_01162018 (rev OSORA PRA).pdf Yes Yes Fillable Printable

Health Health Care Services

 

380 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 380 0 0 70 0 310
Annual IC Time Burden (Hours) 6,246 0 0 -4,695 0 10,941
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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