Information Collection Request

Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments (CMS-10062)

ICR 202002-0938-018 · OMB 0938-0878 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
RAPS Inbound Record Layout 08192020.pdf Supplementary Document Uploaded 2020-08-27 Available
CMS-10062 Supporting_Statement_A -- Clean.docx Supporting Statement A Uploaded 2020-08-27 Available
Response to Public Comments - CMS-10062_01282020.docx Supplementary Document Uploaded 2020-03-04 Repair queued
CMS-10062 Crosswalk.pdf Supplementary Document Uploaded 2020-03-04 Available

IC Document Collections

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2023 36 Months From Approved 08/31/2020
111,738,834 0 82,830,000
5,586,942 0 40,650
0 0 0





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table that charts list of burden
IC Title Form No. Form Name
Collection of Diagnostic Data from Medicare Advantage Organizations for Risk Adjusted Payments Supporting Reg 42 CFR Part 422 & 423 Subparts F and G

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 111,738,834 82,830,000 0 0 28,908,834 0
Annual Time Burden (Hours) 5,586,942 40,650 0 0 5,546,292 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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