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Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Medicare Parts C and D Improper Payment Measure (IPM) (CMS-10811)
Agency IC Tracking Number:
OFM
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
Appendix A
CY2024_Part C IPM Survey Questions
CY2024_Part C IPM_Survey Questions.docx
Yes
Yes
Fillable Fileable
Other-CY24 Part C IPM Sampled MAOs
Appendix A-2_CY 2024_Part C IPM_Sampled Sponsors.xlsx
Yes
No
Printable Only
Form and Instruction
Appendix B
Part D IPM Survey Questions
CY2024_Part D IPM_Survey Questions.docx
Yes
Yes
Fillable Fileable
Other-CY24 Part D IPM Sampled Plan Sponsors
Appendix B-2_CY 2024_Part D IPM_Sampled Sponsors.xlsx
Yes
No
Printable Only
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
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
Request for Approval: Supporting Statement
CMS-10811_2026_PRA Submission_Medicare Part C_D IPM_GenIC_Fast-Track_Request for Approval_0938-1382.docx
09/16/2026
Crosswalk: Part C IPM CY2024
Appendix A-1_Part C IPM CY2024_Crosswalk.docx
09/16/2026
Redline: Part C IPM Survey Questions
CY2024_Part C IPM_Survey Questions_REDLINE.docx
09/16/2026
Crosswalk: Part D IPM CY2024
Appendix B-1_Part D IPM CY2024_Crosswalk.docx
09/16/2026
Redline: Part D IPM Survey Questions
CY2024_Part D IPM_Survey Questions_REDLINE.docx
09/16/2026
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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