View Information Collection Request (ICR) Package
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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:
0938-0978
ICR Reference No:
201702-0938-016
Status:
Historical Active
Previous ICR Reference No:
201311-0938-015
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CM-CPC
Title:
Part D Coordination of Benefits Data (CMS-10171)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
09/27/2017
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/27/2017
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2020
36 Months From Approved
09/30/2017
Responses
770,856,393
0
2,402,582
Time Burden (Hours)
938,061
0
5,205,128
Cost Burden (Dollars)
0
0
0
Abstract:
This information is necessary to assist with coordination of prescription drug benefits provided to the Medicare beneficary at the pharmacy.
Authorizing Statute(s):
PL:
Pub.L. 108 - 173 101
Name of Law: Part D- Voluntary 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:
81 FR 91937
12/19/2016
30-day Notice:
Federal Register Citation:
Citation Date:
82 FR 11222
02/21/2017
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
Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers (CMS-10171)
CMS-10171
2017 SPAP Template
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
770,856,393
2,402,582
0
768,453,811
0
0
Annual Time Burden (Hours)
938,061
5,205,128
0
-4,267,067
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
This 2017 iteration sets out a decrease in administrative burden (-4,267,067 hours = (938,061 proposed hours - 5,205,128 hours relative to the 2013 authorization) as a result of several factors, including: (1) process improvements including additional automation, (2) stable transaction sets with have eliminated programming costs, (3) experience requirements, (4), a decrease in the number of state programs, (5) computerization of the process which CMS uses to communicate with State Pharmacy Assistance Programs (SPAPs) and (6) the elimination of lump sum programs.
Annual Cost to Federal Government:
$9,000,000
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov
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:
02/27/2017
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