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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
CMS-10811. Medicare Parts C and D Improper Payment Measure (IPM) (REVISON)
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
CMS-10811
CMS-10811.Appendix A_Part C IPM Survey Questions
CMS-10811.Appendix A_Part C IPM Survey Questions.docx
Yes
Yes
Fillable Fileable
Form and Instruction
CMS-10811
CMS-10811.Appendix B_Part D IPM Survey Questions
CMS-10811.Appendix B_Part D IPM Survey Questions.docx
Yes
Yes
Fillable Fileable
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:
900
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
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
900
0
900
0
0
0
Annual IC Time Burden (Hours)
45
0
45
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
CMS-10811. PRA Submission_Medicare Part C_D IPM_GenIC_Fast-Track_Request for Approval_2024
CMS-10811. PRA Submission_Medicare Part C_D IPM_GenIC_Fast-Track_Request for Approval_2024.docx
10/15/2024
CMS-10811.Appendix A-1_Part C IPM Survey Question Revisions_Crosswalk
CMS-10811.Appendix A-1_Part C IPM Survey Question Revisions_Crosswalk.docx
10/15/2024
CMS-10811.Appendix A-2_CY 2022_Part C IPM_Sampled MAOs
CMS-10811.Appendix A-2_CY 2022_Part C IPM_Sampled MAOs.xlsx
10/15/2024
CMS-10811.Appendix B-1_Part D IPM Survey Question Revisions_Crosswalk
CMS-10811.Appendix B-1_Part D IPM Survey Question Revisions_Crosswalk.docx
10/15/2024
CMS-10811.Appendix B-2_CY 2022_Part D IPM_Sampled Plan Sponsors
CMS-10811.Appendix B-2_CY 2022_Part D IPM_Sampled Plan Sponsors.xlsx
10/15/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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The .gov means it's official.
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