Medicare Advantage and Prescription Drug Benefit Program: Final Marketing Provisions referenced in 42 CFR 422.111(a)(3) and 423.128(a)(3)

Medicare Advantage and Prescription Drug Program: Final Marketing Provisions CFR 422.111(a)(3) and 423.128 (a)(3)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1051 can be found here:

Documents and Forms

Document Name Document Type
2015_Cost_Plan_ANOC_EOC_PRA_final.pdf Instruction
2015_DE_SNP_ANOC_EOC_PRA_final.pdf Instruction
2015_HMO_MA_ANOC_EOC_PRA_final.pdf Instruction
2015_HMO_MAPD_ISNP_CSNP_ANOC_EOC_PRA_final.pdf Instruction
2015_MSA_ANOC_EOC_PRA_final.pdf Instruction
2015_PDP_ANOC_EOC_PRA_final.pdf Instruction
2015_PFFS_ANOC_EOC_PRA_final.pdf Instruction
2015_PPO_MA_ANOC_EOC_PRA_final.pdf Instruction
2015_PPO_MAPD_ISNP_CSNP_ANOC_EOC_PRA_final.pdf Instruction
AttachmentA_2015 ANOC_EOC Crosswalk for CMS Review_508compliant_01232014.docx Crosswalk IC Document

Information Collection (IC) Details

IC Title:	Medicare Advantage and Prescription Drug Benefit Program: Final Marketing Provisions referenced in 42 CFR 422.111(a)(3) and 423.128(a)(3)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 422.111(a)(3) 42 CFR 423.128(a)(3)

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	2015_Cost_Plan_ANOC_EOC_PRA_final.pdf	Yes	No	Fillable Printable
Instruction	2015_DE_SNP_ANOC_EOC_PRA_final.pdf	Yes	No	Fillable Printable
Instruction	2015_HMO_MA_ANOC_EOC_PRA_final.pdf	Yes	No	Fillable Printable
Instruction	2015_HMO_MAPD_ISNP_CSNP_ANOC_EOC_PRA_final.pdf	Yes	No	Fillable Printable
Instruction	2015_MSA_ANOC_EOC_PRA_final.pdf	Yes	No	Fillable Printable
Instruction	2015_PDP_ANOC_EOC_PRA_final.pdf	Yes	No	Fillable Printable
Instruction	2015_PFFS_ANOC_EOC_PRA_final.pdf	Yes	No	Fillable Printable
Instruction	2015_PPO_MA_ANOC_EOC_PRA_final.pdf	Yes	No	Fillable Printable
Instruction	2015_PPO_MAPD_ISNP_CSNP_ANOC_EOC_PRA_final.pdf	Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 770	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	770	30	740
Annual IC Time Burden (Hours)	9,240	360	8,880
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Crosswalk	AttachmentA_2015 ANOC_EOC Crosswalk for CMS Review_508compliant_01232014.docx	01/28/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.