Small Biotech Exception (Drugs Acquired After December 31, 2021)

Small Biotech Exception (CMS-10844) - IRA

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1443 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10844 Small Biotech Exception (Drugs Acquired After December 31, 2021) Form and Instruction
CMS-10844 Small Biotech Exception Information Collection Request F SBE ICR_Form_CLEAN_508.pdf Form and Instruction
CMS-10844 Small Biotech Exception Information Collection Request F SBE ICR_Form_Clean.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Small Biotech Exception (Drugs Acquired After December 31, 2021)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10844	Small Biotech Exception Information Collection Request Form	SBE ICR_Form_Clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	12	12
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.