Information Collection Request

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

ICR 201908-0938-005 · OMB 0938-1115 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Crosswalk_01082020.xlsx Supplementary Document Uploaded 2020-01-22 Available
Supporting Statement A_01222020.docx Supporting Statement A Uploaded 2020-01-22 Available
Supporting Statement B_03062019.docx Supporting Statement B Uploaded 2019-08-26 Available
60-Day Comment Response Document.xlsx Supplementary Document Uploaded 2019-08-26 Available
Crosswalk_061719.xlsx Supplementary Document Uploaded 2019-08-26 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
194762 Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2023 36 Months From Approved 03/31/2021
553 0 574
15,332 0 24,050
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 CFR 422.516(g) and 423.514(g)) CMS-10305 Organizational Assessment Instrument

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 553 574 0 -21 0 0
Annual Time Burden (Hours) 15,332 24,050 0 -8,718 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No