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
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 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
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.

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