OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Medicare Advantage Program and Supporting Regulations (CMS-R-267)

OMB 0938-0753 · HHS/CMS.

OMB 0938-0753

Medicare Advantage (MA) organizations (formerly M+C organizations) and potential MA organizations (applicants) use the information collected based on the regulations at 42 CFR 422 to comply with the application requirements and the MA contract requirements. CMS uses the information collected based on the regulations at 42 CFR 422 to approve contract applications, monitor compliance with contract requirements, make proper payment to MA organizations, determine compliance with the new prescription drug benefit requirements established by the MMA, and to ensure that correct information is disclosed to Medicare beneficiaries, both potential enrollees and enrollees.

The latest form for Medicare Advantage Program and Supporting Regulations (CMS-R-267) expires 2021-12-31 and is listed under ICR 201905-0938-018.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
CMS-R-267- Supporting Statement A (CMS-4201-P version 4).docxSupporting Statement A
Medicare Advantage Program and Supporting Regulations (MAOs) Information collection
Proposed Changes (CMS-4201-P, RIN 0938-AU96) Other-CMS Model Document: MA Provider Termination Notice
Medicare Advantage Program and Supporting Regulations (States) Information collection
Medicare Advantage Program and Supporting Regulations (Beneficiaries) Information collection

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202301-0938-006 Revision of a currently approved collection 2023-01-12 Comment filed on proposed rule and continue
202006-0938-010 Revision of a currently approved collection 2020-12-10
202003-0938-005 Revision of a currently approved collection 2020-03-09 Comment filed on proposed rule and continue
201905-0938-018 Revision of a currently approved collection 2019-07-05 Approved with change
201903-0938-007 Revision of a currently approved collection 2019-03-15 Comment filed on proposed rule and continue
201804-0938-017 Reinstatement with change of a previously approved collection 2018-04-19 Approved without change
201712-0938-012 Reinstatement with change of a previously approved collection 2017-12-26 Comment filed on proposed rule
201309-0938-022 Reinstatement without change of a previously approved collection 2013-09-19 Approved without change
200806-0938-001 Revision of a currently approved collection 2008-06-05 Approved with change
200504-0938-004 Revision of a currently approved collection 2005-04-27 Approved with change
200208-0938-004 Extension without change of a currently approved collection 2002-08-05 Approved without change
200105-0938-002 Reinstatement with change of a previously approved collection 2001-05-03 Approved without change
200008-0938-009 Revision of a currently approved collection 2000-08-23 Withdrawn and continue
199812-0938-009 New collection (Request for a new OMB Control Number) 1998-12-14 Approved without change

OMB Details

Medicare Advantage Program and Supporting Regulations (MAOs)

Federal Enterprise Architecture: Health - Health Care Services