View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Applications for Medicare Part D Plans; PDP Plans, MA-PD Plans, Cost Plans, PACE Organizations, SAE and EGWP
 
No Modified
 
Mandatory
 
42 CFR 423.153 42 CFR 423.440 42 CFR 423.112 42 CFR 423.514 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 Solicitation for Applications for New Employer/Union Direct Contract Medicare Advantage Prescription Drug Plan (MA-PD) Sponsors 2010 Direct Contract MA-PD_clean081308.doc Yes Yes Paper Only
Form and Instruction CMS-10137 2010 Solicitation for Applications for New Employer/Union Direct Contract Prescription Drug Plan (PDP) Sponsors 2010 Direct Contract PDP_clean081308.doc Yes Yes Paper Only
Form and Instruction CMS-10137 Application Instructions for Cost Plan Sponsors to Offer New Employer/Union-Only Group Waiver Plans (EGWPs) 2010 EGWP Cost Application_clean081108.doc Yes Yes Paper Only
Form and Instruction CMS-10137 2010 Application Instructions for PDP Sponsors to Offer New Employer/Union-Only Group Waiver Plans (EGWPs) 2010 EGWP PDP Application_clean081108.doc Yes Yes Paper Only
Form and Instruction CMS-10137 Medicare Part D Application for New PACE Organizations 2010 PACE Part D_clean081108.doc Yes Yes Paper Only
Form and Instruction CMS-10137 Solicitation for Applications for New Cost Plan Sponsors Contract Year 2010 2010 Part D Cost_clean081108.DOC Yes Yes Paper Only
Form and Instruction CMS-10137 Solicitation for Applications for New Medicare Advantage Prescription Drug Plan (MA-PD) Sponsors 2010 Part D MAPD_clean081108.doc Yes Yes Paper Only
Form and Instruction CMS-10137 Solicitation for Applications for New Prescription Drug Plans (PDP) Sponsors 2010 Part D PDP_clean081108.doc Yes Yes Paper Only
Form and Instruction CMS-10137 2010 PART D SERVICE AREA EXPANSION APPLICATION 2010 Part D SAE application_clean081108.doc Yes Yes Paper Only
Other-Redline TK 2010 Direct Contract MA-PD Application.doc Yes Yes Paper Only
Other-Redline TK 2010 Direct Contract PDP Application.doc Yes Yes Paper Only
Other-Redline TK 2010 EGWP Cost Application.doc Yes Yes Paper Only
Other-redline TK 2010 EGWP PDP Application.doc Yes Yes Paper Only
Other-redline TK 2010 PACE Part D.doc Yes Yes Paper Only
Other-redline TK 2010 Part D Cost.DOC Yes Yes Paper Only
Other-redline TK 2010 Part D MAPD.doc Yes Yes Paper Only
Other-redline TK 2010 Part D PDP_draft_0729.doc Yes Yes Paper Only
Other-redline TK 2010 Part D SAE application.doc Yes Yes Paper Only
Other-revision High level Summ_2010_Application_Revisions_508 and comments.doc Yes Yes Paper Only
Other-Red line Red line 2010 Part D PDP_508.doc Yes Yes Paper Only
Other-Red Line Red line 2010 Part D MAPD_508.doc Yes Yes Paper Only
Other-Red Line Red line 2010 Part D Cost_508.doc Yes Yes Paper Only
Other-redline Red line 2010 PACE Part D_508.doc Yes Yes Paper Only
Other-1 2010 Part D Cost_508.doc Yes Yes Paper Only
Other-2 2010 Part D SAE application_508.doc Yes Yes Paper Only
Other-2 2010 Part D PDP_508.doc Yes Yes Paper Only
Other-2 2010 Part D MAPD_508.doc Yes Yes Paper Only
Other-3 2010 PACE Part D_508.doc Yes Yes Paper Only
Other-4 Red line 2010 Part D SAE application_508.doc Yes Yes Paper Only

Health Health Care Services

 

455 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  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 455 0 0 0 0 455
Annual IC Time Burden (Hours) 11,890 0 0 0 0 11,890
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
High level Summ_2010_Application_Revisions_081108 High level Summ_2010_Application_Revisions_081108.DOC 09/08/2008
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.