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Solicitation for Applications for Medicare Prescription Drug Plan 2018 Contracts
 
No Modified
 
Mandatory
 
42 CFR 423.153 42 CFR 423.514 42 CFR 423.112 42 CFR 423.440 42 CFR 423.512 42 CFR 423.120

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10137 Medicare Part D Application for New PACE Organizations 2017 Contract Year 2017 PACE Part D Application PRA_v30day [rev 10-04-2016 by OSORA PRA].pdf Yes Yes Fillable Printable
Form and Instruction CMS-10137 Solicitation for Applications for Medicare Prescription Drug Plan 2018 Contracts 2018 Part D Application_PRA_v30day CLEAN [rev 11-04-2016 by OSORA PRA].pdf Yes Yes Fillable Printable

Health Health Care Services

 

160 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 160 0 -70 0 0 230
Annual IC Time Burden (Hours) 1,565 0 -544 0 0 2,109
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk - Application Part_D_Summ_2018_Application_Revisions_technical__substantive_v60_day.docx 11/04/2016
Redline/Strikeout - Application 2018 Part D Application_PRA_v60day REDLINE.docx 11/04/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.