Pharmacy Billing Requirements

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
1215-0194 Supporting Stmt 10-28-2009final.doc	Supporting Statement A	Uploaded 2009-10-28	Available
DOL-ESA-6 (BLBA) and DOL-ESA-49 (EEOICPA) 1215-0194.pdf	Supplementary Document	Uploaded 2007-01-10	Available
DOL-GOVT-1 (FECA).pdf	Supplementary Document	Uploaded 2007-01-10	Available
20 CFR 725.701 BLBA regs.pdf (2006 clearance).pdf	Supplementary Document	Uploaded 2007-01-10	Available
20 CFR 30.701 EEOICPA regs.pdf(2006 clearance).pdf	Supplementary Document	Uploaded 2007-01-10	Available
20 CFR 10.801 FECA regs.pdf(2006 clearance).pdf	Supplementary Document	Uploaded 2007-01-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
38474	Pharmacy Billing Requirements	Instruction	Modified

ICR Details

OMB Control No: 1215-0194	ICR Reference No: 200907-1215-004
Status: Historical Active	Previous ICR Reference No: 200701-1215-008
Agency/Subagency: DOL/ESA	Agency Tracking No:
Title: Pharmacy Billing Requirements
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/30/2009
	Date Received in OIRA: 11/17/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2012	36 Months From Approved	03/31/2010
Responses	1,463,800	0	1,463,792
Time Burden (Hours)	121,494	0	121,495
Cost Burden (Dollars)	0	0	0

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Abstract: The NCPDP Standardized Pharmacy Billing Data Requirements are the electronic billing format used by pharmacies throughout the country to request payment for prescription drugs through data clearinghouses. They identify the provider, claimant, prescribing physician, drug by NDC (National Drug Code) number, prescription volume and charge. Similar data elements are required to process paper-based pharmacy bills.

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Authorizing Statute(s): US Code: 5 USC 8101 et seq Name of Law: FECA
   US Code: 30 USC 901 et seq Name of Law: BLBA
   US Code: 42 USC 7384 et seq Name of Law: EEOICPA
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 37733	07/29/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 59243	11/17/2009
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Pharmacy Billing Requirements

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ICR Summary of Burden

table that charts list of burden

	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	1,463,800	1,463,792	0	0	8	0
Annual Time Burden (Hours)	121,494	121,495	0	0	-1	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: There is a decrease of one hour in the number of pharmacy bills submitted to the FECA program in recent years. Therefore, there is a decrease of -1 hour.

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Annual Cost to Federal Government: $2,371,618

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)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 11/17/2009

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