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Federal forms, ICRs, and supporting documents

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.

Documents and Forms
Document Name
Document Type
Other-Screen Shots
Other-Screen Shots
Instruction
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP): CY 2008
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 422.Subpart F 42 CFR 422.Subpart G 42 CFR 423.Subpart F 42 CFR 423.Subpart G

Document Type Form No. Form Name Instrument File URL 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

Health Health Care Services

 

550 25
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 6,050 0 0 1,220 0 4,830
Annual IC Time Burden (Hours) 42,350 0 0 6,160 0 36,190
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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