Non Substantive Change Request Memo

To: Jamie Wilson

Office of Information and Regulatory Affairs (OIRA)

Office of Management and Budget (OMB)

From: William Parham

Office of Strategic and Regulatory Affairs

PRA Staff

Date: September 18, 2025

Subject: Non-Substantive Change Request – Medicare Part C Reporting Requirements 42CFR §422.516 (a) (CMS-10261; OMB # 0938-1054)

This memo requests approval of non-substantive changes to the approved information collection CMS-10261 (OMB # 0938-1054).

Background

Sections 1857(e)(1) and Section 1860D–12(b)(3)(D) of the Social Security Act provides the Secretary with broad authority to establish contract terms with Medicare Advantage organizations (MAOs) (Part C), including terms that require the sponsor to provide the Secretary with information as the Secretary may find necessary and appropriate. Pursuant to our statutory authority, we codified these information collections at 42 CFR § 422.516.

42 CFR §422.516(a) require each MAO to have a procedure to develop, compile, evaluate, and report to the Centers for Medicare & Medicaid Services (CMS), to its enrollees, and to the general public, at the times CMS requires statistics indicating the following: cost of its operations, procedures related to and utilization of its services and items, availability, accessibility, and acceptability of its services, to the extent practical, developments in the health status of its enrollees, information demonstrating that the MAO has a fiscally sound operation ) and other matters that CMS may require.

Overview of Requested Changes

Subsequent to OMB’s approval on January 2, 2025, CMS updated the Medicare CY 2026 Part C Reporting Requirements. Updates were made to correct clerical errors, streamline text, and update the CMS resource mailbox. No other changes are being made, and there are no program changes or burden adjustments necessary due to the updates.