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Federal forms, ICRs, and supporting documents

Information Collection

2009 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP)-CMS-10142

IC 37926 under ICR 200801-0938-002 · OMB 0938-0944.

Documents and Forms
Document Name
Document Type
Other-Form and Instructions
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

2009 Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP)-CMS-10142
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 423.350 42 CFR 423.279 42 CFR 423.286 42 CFR 423.293 42 CFR 423.301 42 CFR 423.308 42 CFR 423.315 42 CFR 423.322 42 CFR 423.329 42 CFR 423.336 42 CFR 423.343 42 CFR 422.250 42 CFR 422.252 42 CFR 422.254 42 CFR 422.256 42 CFR 422.258 42 CFR 422.262 42 CFR 422.264 42 CFR 422.266 42 CFR 422.270 42 CFR 422.300 42 CFR 422.304 42 CFR 422.306 42 CFR 422.308 42 CFR 422.310 42 CFR 422.312 42 CFR 422.314 42 CFR 422.316 42 CFR 422.318 42 CFR 422.320 42 CFR 422.322 42 CFR 422.324 42 CFR 423.251 42 CFR 423.258 42 CFR 423.265 42 CFR 423.272 42 CFR 423.346

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Form and Instructions CMS-10142 PRA 12-28.ZIP Yes Yes Paper Only

Health Health Care Services

 

550 25
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 0 0 6,050
Annual IC Time Burden (Hours) 42,350 0 0 0 0 42,350
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Summary of Changes CMS-10142 Attachment C, CY2009 BPT Changes.doc 01/03/2008
Attachment E-1 MA BPT instructions redline Attachment E-1 MA BPT instructions redline.pdf 01/03/2008
Attachment E-2 PD BPT instructions redline Attachment E-2 PD BPT instructions redline.pdf 01/03/2008
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.