Information Collection Request

Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) (CMS-10305)

ICR 202504-0938-014 · OMB 0938-1115 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10305 Organizational Assessment Instrument Form and Instruction Modified Available
CMS-10305.Non Substantive Change Request Memo_Medicare Part C &D Data Validation_Clean.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-24 Available
CMS-10305.Non Substantive Change Request Memo_Medicare Part C &D Data Validation_Clean.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-24 Repair queued
CMS-10305_Supporting Statement A_Clean.docx Supporting Statement A Uploaded 2025-04-15 Available
CMS-10305_Supporting Statement A_Clean.docx Supporting Statement A Uploaded 2025-04-15 Repair queued
CY 2025 to CY 2026 DV Crosswalk.xlsx Supplementary Document Uploaded 2025-04-15 Available
CY 2025 to CY 2026 DV Crosswalk.xlsx Supplementary Document Uploaded 2025-04-15 Repair queued
CMS-10305_Supporting Statement B_Clean.docx Supporting Statement B Uploaded 2025-04-15 Available
CMS-10305_Supporting Statement B_Clean.docx Supporting Statement B Uploaded 2025-04-15 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
194762 Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) Form and Instruction ModifiedOrganizational Assessment Instrument
194762 Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) 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
840 0 809
10,920 0 10,500
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) CMS-10305

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 840 809 0 0 31 0
Annual Time Burden (Hours) 10,920 10,500 0 0 420 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No