Administrative Burden Related to Audits of the Risk Adjustment Covered Issuers (§153.410(d); §153.620(c))

Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment (CMS-10401)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1155 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	Administrative Burden Related to Audits of the Risk Adjustment Covered Issuers (§153.410(d); §153.620(c))	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 153.410(c) 45 CFR 153.620(c)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-120	120
Annual IC Time Burden (Hours)	-10,800	10,800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.