Medicare Endorsed Prescription Drug Card Assistance Initiative

ICR 200209-0938-003

OMB: 0938-0882

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0938-0882 200209-0938-003
Historical Active
HHS/CMS
Medicare Endorsed Prescription Drug Card Assistance Initiative
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 11/13/2002
Retrieve Notice of Action (NOA) 09/11/2002
  Inventory as of this Action Requested Previously Approved
11/30/2005 11/30/2005
15 0 0
5,189 0 0
0 0 0

CMS is publishing a final rule which will implement a prescriptio discount card assistance initiative. Discount care programs can receive a Medicare endorsement if their sponsors' submit an application to CMS (in response to a solcitation to be released by CMS) which demonstrates the program meets the criteria for a Medicare endorsement set out in the final rule. The endorsed programs on request, will make information available for Medicare beneficiaries to use to compare the programs for possible enroll- ment in one of them. A website developed by a cooperative (organized and funded by the endorsed programs) will list .......

None
None


No

1
IC Title Form No. Form Name
Medicare Endorsed Prescription Drug Card Assistance Initiative CMS-10070

  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 15 0 0 15 0 0
Annual Time Burden (Hours) 5,189 0 0 5,189 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/11/2002


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