Information Collection

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

IC 194762 under ICR 202509-0938-003 · OMB 0938-1115.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10305 Organizational Assessment Instrument Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g))	Form and Instruction
CY 2026 DV_Appendix E_.docx	Instruction
CY 2026 DV_Appendix E_.docx	Instruction
CY 2026 DV_Procedure_Manual_.docx	Instruction
CY 2026 DV_Procedure_Manual_.docx	Instruction
CMS-10305 Organizational Assessment Instrument CY 2026 DV_EES_FINAL_.xlsx	Form and Instruction
CMS-10305 Organizational Assessment Instrument CY 2026 DV_EES_FINAL_.xlsx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 422.516(a)(3),(a)(4),(a)(6) 42 CFR 423.514 (a)(1) (a) (2) 42 CFR 422.516_(a)(1),(a)(2) 42 CFR 423.514 (a)(3) (a) (4) (a) (6)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction		Yes	No	Printable Only
Instruction		Yes	No	Fillable Printable
Form and Instruction	CMS-10305	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 840

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	840	840
Annual IC Time Burden (Hours)	10,920	10,920
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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