Information Collection

Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP): CY 2008

IC 37926 under ICR 200703-0938-001 · OMB 0938-0944.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0944 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CMS-10142 Attachment D-1, MA BPT screen shots.pdf	Other-Screen Shots
CMS-10142 Attachment D-2, PD BPT screen shots.pdf	Other-Screen Shots
CMS-10142 Attachment E-1, MA BPT instructions.pdf	Instruction
CMS-10142 Attachment E-2, PD BPT instructions.pdf	Instruction

IC Title:

Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP): CY 2008

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 422.Subpart F 42 CFR 422.Subpart G 42 CFR 423.Subpart F 42 CFR 423.Subpart G

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	CMS-10142 Attachment E-2, PD BPT instructions.pdf	Yes	Yes	Paper Only
Other-Screen Shots	CMS-10142 Attachment D-1, MA BPT screen shots.pdf	Yes	Yes	Paper Only
Other-Screen Shots	CMS-10142 Attachment D-2, PD BPT screen shots.pdf	Yes	Yes	Paper Only
Instruction	CMS-10142 Attachment E-1, MA BPT instructions.pdf	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 550

Number of Respondents for Small Entity: 25

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	6,050	1,220	4,830
Annual IC Time Burden (Hours)	42,350	6,160	36,190
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.