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 423.514 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
Instruction Yes Yes Paper Only
Instruction Yes Yes Paper Only
Instruction Yes Yes Paper Only
Instruction Yes Yes Paper Only
Instruction Yes Yes Paper Only
Instruction Yes Yes Paper Only
Instruction Yes Yes Paper Only
Instruction Yes Yes Paper Only
Instruction 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
2010 Chart for New EGWP Applicants _FINAL 03/20/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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