Information Collection

Identification and Selection of Renegotiation-Eligible Drugs

IC 277593 under ICR 202509-0938-014 · OMB 0938-1443.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10844 Identification and Selection of Renegotiation-Eligible Drugs	Form and Instruction
Form CMS-10844 Negotiation Program Drug Selection Information Collection Forms Identification and Selection of Renegotiation-Eligible Drugs	Form and Instruction
CMS-10844 Negotiation Program Drug Selection Information Collectio CMS-10844 Initial Price Applicability Year 2028_ Negotiation Program Drug Selection Information Collection Forms.docx	Form and Instruction
CMS-10844 Negotiation Program Drug Selection Information Collectio CMS-10844 Initial Price Applicability Year 2028 Negotiation Program Drug Selection Information Collection Forms.docx	Form and Instruction
CMS-10844 Initial Price Applicability Year 2028 30-day Negotiation Program Drug Selection Information Collection Forms redline of proposed changes.pdf Track Change - Negotiation Program Drug Selection Information Collection Forms	IC Document
CMS-10844 Initial Price Applicability Year 2028 60-day Drug Selection Information Collection Forms redline of proposed revisions.pdf Track Change - Negotiation Program Drug Selection Information Collection Forms	IC Document

IC Title:

Identification and Selection of Renegotiation-Eligible Drugs

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10844				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	3,125	3,125
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Track Change - Negotiation Program Drug Selection Information Collection Forms		11/07/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].