Information Collection

Small Biotech Exception

IC 259843 under ICR 202606-0938-004 · OMB 0938-1443.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10844 Negotiation Program Drug Selection Information Collection Forms Small Biotech Exception	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 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:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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: 30

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
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-30	30
Annual IC Time Burden (Hours)	-292	292
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].