Information Collection Request

Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) (CMS-10305)

ICR 202610-0938-004 · OMB 0938-1115 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10305 Examination Engagement Standards (EES) Form and Instruction Modified Available
Form CMS-10305 Organizational Assessment Instrument (OAI) Form and Instruction Modified Available
2027 DV_2026 to 2027 DV Crosswalk_508_Clean..xlsx Supplementary Document Uploaded 2026-10-16 Available
0938-1115 (CMS-10305) - Non Substantive Change Request Memo.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-10-16 Available
CMS-10305_Supporting Statement A_Non-Sub_Clean.docx Supporting Statement A Uploaded 2026-10-15 Available
CMS-10305_Supporting Statement B_.docx Supporting Statement B Uploaded 2025-09-03 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
194762 Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) Form and Instruction ModifiedExamination Engagement Standards (EES)
194762 Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) Form and Instruction ModifiedOrganizational Assessment Instrument (OAI)
194762 Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
12/31/2028 12/31/2028
840 840
10,920 10,920
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) CMS-10305, CMS-10305 ,  

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 840 840 0 0 0 0
Annual Time Burden (Hours) 10,920 10,920 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No