Annual Reporting and Recordkeeping Requirements

Medical Loss Ratio (MLR) Data Form for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10476)

OMB: 0938-1232

IC ID: 209359

Documents and Forms

Document Name Document Type
Attachment C-CY 2023 MLR Reporting Instructions_final.docx Instruction
CMS-10476 MLR Report Workbook Attachment B - CY2023 MLR Report Workbook_clean.pdf www.cms.gov/files/zip/cy2018-mlr-workbook-and-instructionszip Form
Attachment C-CY 2023 MLR Reporting Instructions_redline (version 2).docx Track Change: MLR Report Filing Instructions IC Document
Attachment B - CY2023 MLR Report Workbook_redline (version 2).docx Track Change: MLR Report Workbook IC Document