Information Collection Request

Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a) (CMS-10261)

ICR 202410-0938-019 · OMB 0938-1054 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
0938-1054 - Non Substantive Change Request Memo 10.16.2024.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-10-16 Repair queued
0938-1054 - Non Substantive Change Request Memo 10.16.2024.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-10-16 Repair queued
Part C reporting requirements and tech specs crosswalk october 16 2024.xlsx Supplementary Document Uploaded 2024-10-16 Available
Part C reporting requirements and tech specs crosswalk october 16 2024.xlsx Supplementary Document Uploaded 2024-10-16 Repair queued
30-day PRA responses_20231115_clean.docx Supplementary Document Uploaded 2023-11-28 Available
30-day PRA responses_20231115_clean.docx Supplementary Document Uploaded 2023-11-28 Repair queued
Supporting Statement A.508clean.docx Supporting Statement A Uploaded 2023-11-28 Repair queued
Supporting Statement A.508clean.docx Supporting Statement A Uploaded 2023-11-28 Repair queued
CY2021 to CY2024 Crosswalk_508.9.19.2023_60 and 30 Day Crosswalk.pdf Supplementary Document Uploaded 2023-09-25 Available
CY2021 to CY2024 Crosswalk_508.9.19.2023_60 and 30 Day Crosswalk.pdf Supplementary Document Uploaded 2023-09-25 Repair queued
CY2021 to CY2024 Crosswalk_20230210_508.pdf Supplementary Document Uploaded 2023-09-25 Available
CY2021 to CY2024 Crosswalk_20230210_508.pdf Supplementary Document Uploaded 2023-09-25 Repair queued
60-day PRA responses_08-29-2023_for 30-day publication.docx Supplementary Document Uploaded 2023-09-25 Available
60-day PRA responses_08-29-2023_for 30-day publication.docx Supplementary Document Uploaded 2023-09-25 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
186859 Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2025 12/31/2025 12/31/2025
6,687 0 6,687
187,979 0 187,979
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a)

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 6,687 6,687 0 0 0 0
Annual Time Burden (Hours) 187,979 187,979 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No