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Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g))
Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g)) (CMS-10305)
OMB: 0938-1115
IC ID: 194762
OMB.report
HHS/CMS
OMB 0938-1115
ICR 202402-0938-012
IC 194762
( )
Documents and Forms
Document Name
Document Type
CY 2023 DV Appendix B_20221014_508.pdf
Instruction
CY 2023 DV Appendix B_20221014_508.pdf
Instruction
CY 2025 DV_Procedure_Manual_20240220_DRAFT_508.pdf
Instruction
CY 2025 DV_Procedure_Manual_20240220_DRAFT_508.pdf
Instruction
CMS-10305 Organizational Assessment Instrument
CY 2025 DV_Appendix E_20240220_508_DRAFT_clean_508.pdf
Form and Instruction
CMS-10305 Organizational Assessment Instrument
CY 2025 DV_Appendix E_20240220_508_DRAFT_clean_508.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Medicare Part C and Part D Data Validation (42 CFR 422.516(g) and 423.514(g))
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
42 CFR 423.514 (a)(3) (a) (4) (a) (6)
42 CFR 422.516(a)(3),(a)(4),(a)(6)
42 CFR 423.514 (a)(1) (a) (2)
42 CFR 422.516_(a)(1),(a)(2)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
CY 2023 DV Appendix B_20221014_508.pdf
Yes
No
Printable Only
Instruction
CY 2025 DV_Procedure_Manual_20240220_DRAFT_508.pdf
Yes
No
Fillable Printable
Form and Instruction
CMS-10305
Organizational Assessment Instrument
CY 2025 DV_Appendix E_20240220_508_DRAFT_clean_508.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
809
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
809
0
0
0
0
809
Annual IC Time Burden (Hours)
10,500
0
0
0
0
10,500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.