Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers

Forms and Documents

Document Name	Status
MDBGpraestimate_COB_06_17_2013.xls Supplementary Document	2013-11-14
CROSSWALK -- PDBM-Chapter 14.doc Supplementary Document	2013-11-14
CMS-10171 - Supporting Statement part A [rev 11-8-2013 by OSORA PRA].docx Supporting Statement A	2013-11-14

IC Document Collections

IC ID	Document Title	Status
8840	Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers (CMS-10171) Instruction	Modified

ICR Details

OMB Control No: 0938-0978	ICR Reference No: 201311-0938-015
Status: Historical Active	Previous ICR Reference No: 201008-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No: 20954
Title: Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/14/2014
	Date Received in OIRA: 11/14/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	36 Months From Approved	02/28/2014
Responses	2,402,582	0	248,018
Time Burden (Hours)	5,205,128	0	754,788
Cost Burden (Dollars)	0	0	0

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Abstract: This information is necessary to assist with coordination of prescription drug benefits provided to the Medicare beneficary at the pharmacy.

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Authorizing Statute(s): PL: Pub.L. 108 - 173 101 Name of Law: Part D- Voluntary Prescription Drug Benefit Program
  

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:
	78 FR 40482	07/05/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 67150	11/08/2013
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers (CMS-10171)	CMS-10171	SPAP Plan to Wrap-Around Part D for CY 2014

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ICR Summary 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	2,402,582	248,018	0	0	2,154,564	0
Annual Time Burden (Hours)	5,205,128	754,788	0	0	4,450,340	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: The previous package included a separate guidance document concerning TrOOP balance transfers. That document can be found in the Medicare Prescription Drug Benefit Manual section 50.8.1 which is included in this PRA package. This is a revision of an approved collection. Differences in the burden estimates (57,116 respondents (2013) vs 57,227 respondents (2010), 2,492,582 responses (2013) vs 248,018 responses (2010), and 5,205,128 hr (2013) vs 754,788 hr (2010)) are due to a number of factors. CMS implemented several improvements in the processes used to identify claims supplemental to Part D and, thus, significantly increased the number of N transactions created to report these claims payments to Part D plan sponsors. Therefore, plan sponsors receive and process a higher number of these transactions than were previously estimated. Additionally, CMS, in conjunction with the industry and NCPDP, made a number of improvements to the ATBT process, including revising the scheduling of the transactions to increase the number of transactions occurring in the month immediately following the enrollment change and to incorporate three series of end-of-year transactions for all beneficiaries who changed plans during the contract year. This resulted in an increase in the overall volume of ATBT transactions from our previous estimates. The implementation of enhancements to the eligibility query, including the addition of several new fields in the query response has improved the utility of the transaction for pharmacies and created an increase in the overall number of queries. Therefore, based on our current experience, the previous burden estimates associated with these queries was understated.

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Annual Cost to Federal Government: $9,000,000

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 11/14/2013

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