Information Collection Request

Rebate Reduction Requests underSections 11101 and 11102 of the Inflation Reduction Act (CMS-10858) - IRA

ICR 202405-0938-025 · OMB 0938-1474 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1474 can be found here:

Forms and Documents

Document Name	Status
Form CMS-10858 Rebate Reduction Extension Request Form Form and Instruction	New
Form CMS-10858 Rebate Reduction Request Form Form and Instruction	New
CMS-10858_Supporting Statement_Rebate Reduction Requests.docx Supporting Statement A	2024-06-04
Final clean 30 day notice Rebate Reduction Requests ICR Comment Summary Responses.docx Supplementary Document	2024-06-04
508_Final clean 60 to 30 Day Rebate Reduction Requests ICR Cross Walk_2.docx Supplementary Document	2024-06-04

IC Document Collections

IC ID	Document Title	Status
268249	Rebate Reduction Extension Request Form Form and Instruction	New
268246	Rebate Reduction Request Form Form and Instruction	New

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CMS
OMB Control No	0938-1474
Type of Information Collection	New collection (Request for a new OMB Control Number)
Agency Tracking No	CM-CPC
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31