View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0976	ICR Reference No: 202212-0938-006
Status: Historical Active	Previous ICR Reference No: 202002-0938-017
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/23/2023
	Date Received in OIRA: 12/22/2022
Terms of Clearance: Prior to resubmission, it is requested that the agency develop and submit a Spanish language version of "Notice of Denial of Medicare Prescription Drug Coverage" (CMS-10146) (0938-0976.) Ideally, the agency will submit this additional version of the ICR via a change request prior to the new expiration of 06/2024.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2024	36 Months From Approved	06/30/2023
Responses	2,627,898	0	2,887,866
Time Burden (Hours)	656,975	0	721,967
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	2,627,898	2,887,866	-259,968
Annual Time Burden (Hours)	656,975	721,967	-64,992
Annual Cost Burden (Dollars)	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: No

Burden Reduction Due to:

Short Statement: The total number of denial notices issued has decreased since the 2020 approval of this collection. At the last approval of this package, 2,887,866 denial notices were issued by plans. Using 2020 validated data, 2,627,898 denial notices were issued, representing a decrease of 259,968 denial notices. This resulted in an estimated annual hour burden for this package is 656,975 which represents a decrease of 64,992 hours.

Annual Cost to Federal Government: $1,260

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. Yes

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? No

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

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