Medicare Part C and Part D Program Audit Protocols (CMS-10717)
Revision of a currently approved collection
No
Regular
Approved without change
10/14/2026
07/06/2026
table that charts list comparision
Inventory as of this Action
Requested
Previously Approved
10/31/2029
36 Months From Approved
01/31/2027
30
0
182
12,795
0
36,444
0
0
0
42 CFR 422.502 describes CMS' regulatory authority to evaluate, through inspection or other means, Medicare Advantage Part C organizations. These records include books, contracts, medical records, patient care documentation and other records that pertain to any aspect of services performed, reconciliation of benefit liabilities, and determination of amounts payable. 42 CFR 423.503 states that CMS must oversee a Part D plan sponsor's continued compliance with the requirements for a Part D plan sponsor. 423.514 states that the Part D plan sponsor must have an effective procedure to develop, compile, evaluate, and report to CMS, to its enrollees, and to the general public, at the times and in the manner that CMS requires, statistics regarding areas such as cost of operations, patterns of utilization availability, accessibility, and acceptability of services. CMS developed a strategy to address our oversight and audit responsibilities within the context of limited audit/oversight resources. We have combined all Part C and Part D guides into one universal guide promoting efficiency and effectiveness and reducing financial and time burdens for both CMS and Medicare-contracting entities.
US Code:
42 USC 1395w-112
Name of Law: REQUIREMENTS FOR AND CONTRACTS WITH PRESCRIPTION DRUG PLAN (PDP) SPONSORS
US Code:
42 USC 1395wâ27
Name of Law: CONTRACTS WITH MEDICARE+CHOICE ORGANIZATIONS
CMS reduced the hours necessary to conduct validation activities from 200 hours for all organizations to 165 hours, 100 hours, and 10 hours in regards to the various program audits. In addition to the changes, CMS also removed the burden associated with the Part C Timeliness Monitoring Project. The timeliness monitoring project was included as part of this protocol package, but CMS no longer collects industry wide data or conducts this monitoring effort, so all associated burden has been removed from this supporting statement.
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Yearly Industry-Wide Timeliness Monitoring Project (TMP)