The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs) (CMS-R-262)

Forms and Documents

Document Name	Status
Response to 30-day comments 03282017.pdf Supplementary Document	2017-04-17
CMS-R-262 - CY2018_PBP_Sprtng_Stmnt_rev_04-20-2017 CLEAN.docx Supporting Statement A	2017-04-24
PRA2018_List_of_Changes_2016_12_28_508.pdf Supplementary Document	2017-01-23
CY2018 PRA 60-day comments 01.10.2017.docx Supplementary Document	2017-01-23

IC Document Collections

IC ID	Document Title	Status
43667	CY2018 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262) Instruction	Modified

ICR Details

OMB Control No: 0938-0763	ICR Reference No: 201701-0938-007
Status: Historical Active	Previous ICR Reference No: 201512-0938-009
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: 05/08/2017
	Date Received in OIRA: 02/17/2017
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	05/31/2018	36 Months From Approved	05/31/2017
Responses	5,185	0	5,448
Time Burden (Hours)	50,619	0	52,902
Cost Burden (Dollars)	0	0	0

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Abstract: CMS requires that MA and PDP organizations submit a completed formulary and PBP as part of the annual bidding process. During this process, organizations prepare their proposed plan benefit packages for the upcoming contract year and submit them to CMS for review and approval.

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Authorizing Statute(s): PL: Pub.L. 108 - 173 101 Name of Law: Prescription Drug, Improvement, and Modernization Act of2003 (MMA)
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 75406	10/31/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 7833	01/23/2017
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
CY2018 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	Medication Therapy Management Program (MTMP) ,   CY 2018 PBP Data Entry System Screens - Section A ,   CY 2018 PBP Data Entry System Screens - Section B ,   CY 2018 PBP Data Entry System Screens - Section B (VBID) ,   CY 2018 PBP Data Entry System Screens - Section C ,   CY 2018 PBP Data Entry System Screens - Section D ,   CY 2018 PBP Data Entry System Screens - Section Rx ,   CY 2018 PBP Data Entry System Screens - Section Rx (VBID)

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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	5,185	5,448	0	-263	0	0
Annual Time Burden (Hours)	50,619	52,902	0	-2,283	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: The minimal change to burden is attributable to a decrease in the number of formulary submissions as well as a decrease in the number of reporting organizations. The number of reporting organizations decreased from 552 contracts to 524 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 524 organizations will submit distinct formularies. Changes due to internal decisions made were made to the screenshots for the Formulary, PBP and the MTMP and are reflected in the list of changes.

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Annual Cost to Federal Government: $912,519

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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

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Common Form ICR:  No

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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: 02/17/2017

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