View Information Collection Request (ICR) Package
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View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-0936
ICR Reference No:
200707-0938-001
Status:
Historical Active
Previous ICR Reference No:
200611-0938-011
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
Applications for Medicare Part D plans: PDP Plans, MA-PD Plans, Cost Plans, PACE organizations, SAE and EPOG
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
09/12/2007
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/13/2007
Terms of Clearance:
This collection is approved under the following terms of clearance: Upon publishing a new 60-day and 30-day Federal Register Notice, CMS will provide the public and OMB with a supplemental document that crosswalks all changes (technical and substantive) made to the revised ICR. The document should include an explanation of each change from the previous approval, the reason why the change is necessary and the citation or reference to the statute, regulation or guidance document that support the need for the change. The crosswalk should also address an increase or decrease in burden for each change. .
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2010
36 Months From Approved
09/30/2007
Responses
857
0
216
Time Burden (Hours)
28,122
0
5,316
Cost Burden (Dollars)
0
0
0
Abstract:
The Applications for Part D sponsors to offer qualified prescription drug coverage are completed by entities seeking approval to offer Part D benefits under the Medicare Prescription Drug Benefit program established by section 101 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and is codified in section 1860D of the Social Security Act (the Act).
Authorizing Statute(s):
PL:
Pub.L. 108 - 173 1860D
Name of Law: Medicare Prescription Drug Benefit Program
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
72 FR 13793
03/23/2007
30-day Notice:
Federal Register Citation:
Citation Date:
72 FR 31840
06/08/2007
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Applications for Medicare Part D Plans; PDP Plans, MA-PD Plans, Cost Plans, PACE Organizations, SAE and EPOG
CMS-10137, CMS-10137, CMS-10137, CMS-10137, CMS-10137, CMS--10137
Application New Dug Plans
,
App New Cost Plans
,
EPOG Direct Contract Plans
,
MA Plans
,
SAE Applications
,
EPOG Direct MAPD Plans
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
857
216
0
641
0
0
Annual Time Burden (Hours)
28,122
5,316
0
22,806
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Several attestations were removed from the Part D Applications after emergency approval was granted. These attestations were removed based on subsequent OMB concern raised during the review of the Part C applications. As a result, the burden hours to complete an application were even further reduced then previously calculated. Subsequent to the emergency approval of the Part D applications, CMS received Notices of Intent to apply for the 2008 contract year that far exceeded original expectations. The increase in the number of applicants is the reason that the annual hour burden actually increased from what was approved for emergency clearance (see Supporting Statement for more detail). Number of Applicants increased due to MMA statute allowing Local PPOs into the marketplace for the first time in 2008 and a larger than expected volume of applicants seeking to offer Private Fee For Service plans with Part D.
Annual Cost to Federal Government:
$100,800
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Bonnie Harkless 4107865666
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
07/13/2007
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