Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
MPPP Model Notices Programming	New	1065	21300	8686462	Instruction
					Instruction
					Instruction
					Form and Instruction	CMS-10882	Medicare Prescription Payment Plan Participation Request Form
					Form and Instruction	CMS-10882	Part D Sponsor Notice to Acknowledge Acceptance of Election to the Medicare Prescription Payment Plan
					Form and Instruction	CMS-10882	Part D Sponsor Notice for Failure to Make Payments under the Medicare Prescription Payment Plan
					Form and Instruction	CMS-10882	Part D Sponsor Notice for Failure to Make Payments under Medicare Prescription Payment Plan – Notification of Termination of Participation in the Medicare Prescription Payment Plan
					Form and Instruction	CMS-10882	Part D Sponsor Notice of Voluntary Removal from the Medicare Prescription Payment Plan
Total burden requested under this ICR:		1065	21300	8686462
To view an IC, click on IC Title