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View ICR - OIRA Conclusion

OMB Control No: 0938-0763	ICR Reference No: 201901-0938-009
Status: Historical Active	Previous ICR Reference No: 201801-0938-001
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: 04/05/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/13/2019
Terms of Clearance: Previous terms continue: 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	04/30/2022	36 Months From Approved	04/30/2019
Responses	6,763	0	5,675
Time Burden (Hours)	65,354	0	56,450
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	6,763	5,675	1,088
Annual Time Burden (Hours)	65,354	56,450	8,904
Annual Cost Burden (Dollars)	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 actual plans submitting/PBPs per organization from 10 plans/PBP to 11 plans/PBP, along with an increase in the number of reporting organizations from 520 to 570, as well as an increase in the number of Page 11 formulary submissions from 475 formularies submitted to 493. The number of reporting organizations increased from 520 contracts to 570 contracts based on the most recent numbers extracted from HPMS for organizations planning to provide Medicare to beneficiaries. 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 570 organizations will submit distinct formularies

Annual Cost to Federal Government: $1,207,520

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: Stephan McKenzie 410 786-1943 stephan.mckenzie@cms.hhs.gov