View Information Collection (IC)

View Information Collection (IC)

CY 2011-Applications for Medicare Part D Plans; PDP Plans, MA-PD Plans, Cost Plans, PACE Organizations, SAE and EGWP
 
No Modified
 
Mandatory
 
42 CFR 423.514 42 CFR 423.440 42 CFR 423.153 42 CFR 423.112 42 CFR 423.120 42 CFR 423.512

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10137 Applications for New Cost Plan Sponsors 30 day_2011 Cost formatted.pdf Yes Yes Fillable Fileable Signable
Form and Instruction CMS-10137 Medicare Part D Application for New PACE Organizations 30 day_2011 PACE Part D.pdf Yes Yes Fillable Fileable Signable
Form and Instruction CMS-10137 Applications for New Prescription Drug Plans (PDP) Sponsors 30 day_2011 PDP formatted.pdf Yes Yes Fillable Fileable Signable
Form and Instruction CMS-10137 Part D Service Area Expansion Application 30 day_2011 SAE formatted.pdf Yes Yes Fillable Fileable Signable
Form and Instruction CMS-10137 Applications for New Medicare Advantage - Prescription Drug Plans (MA-PD) Sponsors 30 day_2011MA-PD formatted.pdf Yes Yes Fillable Fileable Signable

Health Health Care Services

 

453 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 453 0 -2 0 0 455
Annual IC Time Burden (Hours) 11,919 0 29 0 0 11,890
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Red line_2011 PDP formatted Red line_2011 PDP formatted.doc 10/02/2009
Red line_2011 Cost formatted Red line_2011 Cost formatted.doc 10/02/2009
Red line_2011 PACE Part D Red line_2011 PACE Part D.doc 10/02/2009
Red line_2011 SAE formatted Red line_2011 SAE formatted.doc 10/02/2009
Red line_2011MA-PD formatted Red line_2011MA-PD formatted.doc 10/02/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.