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View ICR - OIRA Conclusion

OMB Control No: 0938-0763	ICR Reference No: 201801-0938-001
Status: Historical Active	Previous ICR Reference No: 201701-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs) (CMS-R-262)
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: 02/27/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/04/2018
Terms of Clearance: As this ICR is associated with the issuance of annual guidance, this ICR must be revised accordingly each year.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	36 Months From Approved	05/31/2018
Responses	5,675	0	5,185
Time Burden (Hours)	56,450	0	50,619
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	5,675	5,185	446	44
Annual Time Burden (Hours)	56,450	50,619	5,397	434
Annual Cost Burden (Dollars)	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: The increase to burden is attributable to an increase in the number of plans/PBP per organization, along with a decrease in the number of reporting organizations, as well as an increase in the number of formulary submissions and the addition of the new opioid upload. The number of reporting organizations decreased from 524 contracts to 520 contracts based on the most recent numbers extracted from HPMS. This number represents the total number of organizations that will submit at least one (1) PBP. Because an organization can submit a formulary that covers multiple contract numbers, only a subset of the 520 organizations will submit distinct formularies.

Annual Cost to Federal Government: $1,122,229

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]? Yes

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