Information Collection Request

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

ICR 201308-0938-021 · OMB 0938-0578 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-367_Supporting_Statement_(8-15-13).docx Supporting Statement A Uploaded 2013-08-15 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8184 Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 Other-Disclosure Statement Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2016 36 Months From Approved 11/30/2013
9,440 0 9,280
139,712 0 137,344
0 0 8,240,640





Reginfo record details
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, -367b, -367c, and -367d Medicaid Drug Program Monthly and Quarterly Drug Reporting Format

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 9,440 9,280 0 0 160 0
Annual Time Burden (Hours) 139,712 137,344 0 0 2,368 0
Annual Cost Burden (Dollars) 0 8,240,640 0 0 -8,240,640 0


Reginfo record details
  No