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OMB Control No: 0938-0763	ICR Reference No: 202603-0938-012
Status: Received in OIRA	Previous ICR Reference No: 202503-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: CMS Plan Benefit Package (PBP) and Formulary CY 2027 (CMS-R-262) - IRA
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 03/25/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2027
Responses	8,068	8,337
Time Burden (Hours)	44,178	46,026
Cost Burden (Dollars)	0	0

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
CY2027 Plan Benefit Package (PBP) Software and Formulary Submission	CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262, CMS-R-262	, , , , , , , , , ,

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	8,068	8,337	-269
Annual Time Burden (Hours)	44,178	46,026	-1,848
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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The decrease in burden is attributable to a decrease in the number of reporting organizations from 785 to 764, as well as a decrease in the number of formulary submissions from 484 to 427 and estimated reduction in burden hours for completing the formulary submissions. This decrease in respondents and time per response has decreased the overall total burden from 46,026 to 44,178 hours.

Annual Cost to Federal Government: $2,418,182

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? No

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

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