Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-367d Medicaid Drug Rebate Agreement	Form	Modified	Available
Form CMS-367c DDR Drug Product Data	Form	Modified	Repair queued
Form CMS-367b DDR Monthly Pricing Data	Form	Modified	Available
Form CMS-367a DDR Quarterly Pricing Data	Form	Modified	Available
FW0938-0578OMBNOTICEOFACTION.doc	Supplementary Document	Uploaded 0000-00-00	Available
emergency justification for 367 (2).doc	Supplementary Document	Uploaded 0000-00-00	Repair queued
CMS-367 Supporting Statement.doc	Supporting Statement A	Uploaded 0000-00-00	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8184	Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534	Form	Modified	Medicaid Drug Rebate Agreement
8184	Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534	Form	Modified	DDR Drug Product Data
8184	Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534	Form	Modified	DDR Monthly Pricing Data
8184	Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534	Form	Modified	DDR Quarterly Pricing Data
8184	Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534	Instruction	Modified

ICR Details

OMB Control No: 0938-0578	ICR Reference No: 200703-0938-006
Status: Historical Inactive	Previous ICR Reference No: 200405-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 03/15/2007
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 07/10/2007
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/14/2007
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2007	6 Months From Approved	10/31/2007
Responses	2,280	0	2,280
Time Burden (Hours)	54,780	0	54,780
Cost Burden (Dollars)	0	0	0

---

Abstract: Section 1927 requires drug manufactures to enter into and have in effect a rebate agreement with the Federal Government for States to receive funding for drugs dispensed to Medicaid beneficiaries. The Deficit Reduction Act (DRA) of 2005 modified section 1927 to require additional reporting requirements beyond the quarterly data currently collected. CMS form 367 identifies the data fields that manufacturers must submit to CMS on both a monthly and quarterly basis.

Emergency Justfication: See attached file.

---

Authorizing Statute(s): Statute at Large: 19 Stat. 1927
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 5053	02/02/2007
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534	CMS-367a, CMS-367b, CMS-367c, CMS-367d	DDR Quarterly Pricing Data ,   DDR Monthly Pricing Data ,   DDR Drug Product Data ,   Medicaid Drug Rebate Agreement

---

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: As a result of statutory changes, CMS is now required to collect monthly data as well as additional quarterly data, increasing the total number of collections per year from 4 to 16. In addition, there is a data field currently being collected on a quarterly basis that will now be collected on a monthly basis as well. Because of this statutory change, there will be an increased burden on the manufacturers.

---

Annual Cost to Federal Government: $0

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(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: 03/14/2007

---