Mandatory Insurer Reporting (Non-GHP, Private - Maintenance/Administration)

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

OMB: 0938-1074

IC ID: 188583

Information Collection (IC) Details

View Information Collection (IC)

Mandatory Insurer Reporting (Non-GHP, Private - Maintenance/Administration)
 
No Modified
 
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 5 NGHP - 271 Health Care Eligibility Benefit Inquiry Companion Guide for Mandatory Report NGHP v5.pdf Yes No Fillable Printable

Health Health Care Services

Medicare Advantage Prescription Drug System (MARx)  70 FR 60530

20,111 20,111
   
Private Sector Businesses or other for-profits
 
   100 %

  Requested 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 20,111 0 0 1,997 0 18,114
Annual IC Time Burden (Hours) 156,222 0 0 111,994 0 44,228
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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